• Takafumi Toita, Ryo Kitagawa, Tetsutaro Hamano, Kenji Umayahara, Yasuyuki Hirashima, Yoichi Aoki, Masahiko Oguchi, Mikio Mikami, Ken Takizawa, and Cervical Cancer (Vulva Cancer) Committee of Japanese Gynecologic Oncology Group (JGOG).
• Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan. b983255@med.u-ryukyu.ac.jp
• Gynecol. Oncol. 2012 Aug 1; 126 (2): 211-6.

ObjectiveA multicenter phase II trial was conducted to assess the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with high-dose-rate intracavitary brachytherapy (HDR-ICBT) using a low cumulative prescribed dose schedule in patients with locally advanced uterine cervical cancer.MethodsThe Japanese Gynecologic Oncology Group (JGOG) study JGOG1066 enrolled patients with FIGO stages III-IVA uterine cervical cancer who had no para-aortic lymphadenopathy (>10 mm) assessed by CT. Patients received definitive radiotherapy (RT) consisting of external beam whole pelvic RT and HDR-ICBT. The cumulative linear quadratic equivalent dose (EQD2) was 62-65 Gy prescribed at point A. Cisplatin 40 mg/m(2) weekly was administered concurrently with RT for 5 courses.ResultsOf the 72 patients registered, 71 were eligible. With a median follow-up of 28 months, the 2-year progression-free survival rate and pelvic disease progression-free rate were 66% (95% CI, 54% to 76%) and 73% (95% CI, 61% to 82%), respectively. Progression-free survival decreased significantly with increased central tumor size (P=0.036). The 2-year cumulative late complication rates were 24% for all grades, 9% for grade 1, 12% for grade 2, 3% for grade 3, and 0 for grades 4/5.ConclusionsThe JGOG1066 demonstrated that CCRT using HDR-ICBT with a low cumulative RT dose schedule achieved comparable outcome as those achieved with global dose schedules (EQD2=85 Gy) with a lower incidence of late toxicity for locally advanced uterine cervical cancer in a Japanese population.Copyright © 2012 Elsevier Inc. All rights reserved.

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