Analysis of cervical cancer in chinese patients treated with chemoradiation or radiotherapy alone

Abstract

Aim: A retrospective review was performed to compare chemoradiation and radiotherapy alone for the treatment of carcinoma of the cervix in a Hong Kong Chinese population. Patients and Methods: 208 Chinese patients with carcinoma of the cervix stage I to IVA were treated with radical intent between 1994 and 2004. 177 patients (85.1%) received radiotherapy alone and 31 patients (14.9%) received chemoradiation. Radiotherapy consisted of external beam pelvic irradiation followed by low-dose rate brachytherapy and additional parametrial irradiation. Patients in the chemoradiation group received weekly cisplatin during external irradiation. Results: The median age was 65.4 years (range, 32.6 to 90.2 years). The median follow-up time was 5.0 years (range, 0.2 to 12.1 years) for patients in the radiotherapy group and 3.4 years (range, 0.5 to 6.6 years) for patients in the chemoradiation group. At 3 years, the overall survival was 74.7% for the radiotherapy group and 87.5% for the chemoradiation group (p = 0.23). The 3-year disease-free survival was 71.5% for the radiotherapy group and 77.4% for the chemoradiation group (p = 0.23). The overall 3-year actuarial late toxicity was 26.4% (4.3% grade 3 to 4) in the radiotherapy group and 15.2% (0% grade 3 to 4) in the chemoradiation group. Conclusions: Due to the limited number of patients in the chemoradiation group, the survival benefit for chemoradiation for cervical cancer could not be demonstrated. Nevertheless, the treatment was well tolerated by Chinese patients and there was no increase in late toxicities. © 2007 Hong Kong College of Radiologists.