Concurrent cisplatin chemotherapy with intensity-modulated radiotherapy followed by consolidation chemotherapy in early-stage cervical cancer patients with high-risk factors after radical hysterectomy

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2025-06-17 DOI:10.1111/jog.16346

Si-Tong Wang, Gui-Fen Ma, Chun-Li Xiao, Ting-Yan Shi, Li-Bing Xiang, Li Ma, Gen-Lai Lin

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引用次数: 0

Abstract

Objectives

To evaluate the efficacy and toxicity of consolidation chemotherapy (C-CT) following concurrent cisplatin chemotherapy combined with intensity-modulated radiotherapy (IMRT) in patients with early-stage cervical cancer who present high-risk factors (HRFs).

Methods

Between 2013 and 2023, a total of 190 women were included in this retrospective study. Among these, 82 patients received postoperative concurrent chemoradiotherapy (CCRT) with weekly cisplatin and IMRT (45.0–50.4 Gy), followed by C-CT, while 108 patients received CCRT alone. A propensity score matching (PSM) was performed with a ratio of 1:1. Clinical parameters, overall survival (OS), and relapse-free survival (RFS) were analyzed for both groups.

Results

The median follow-up duration was 50.2 months. The 4-year OS rates were 88.7% in the C-CT group and 87.9% in the CCRT-only group (p = 0.886). The 4-year RFS rates were 76.3% for the C-CT group and 80.5% for the CCRT-only group (p = 0.289). In patients with three or more positive lymph nodes, C-CT was associated with significantly improved OS compared to the CCRT-only group (HR 0.14, 95% CI 0.02–0.88, p = 0.036), while RFS showed no significant difference (HR 0.80, 95% CI 0.27–2.32, p = 0.676). However, the incidence of grade 3/4 hematologic toxicity was higher in the C-CT group (16.8% vs. 1.7%, p = 0.009).

Conclusions

Our study found that C-CT following concurrent cisplatin chemotherapy with IMRT did not confer additional benefits over CCRT alone in the majority of early-stage cervical cancer patients with HRFs, except in those with three or more positive lymph nodes.

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有高危因素的早期宫颈癌根治性子宫切除术后顺铂化疗加调强放疗并发巩固化疗

目的评价存在高危因素（hrf）的早期宫颈癌患者顺铂化疗联合调强放疗（IMRT）合并巩固化疗（C-CT）的疗效和毒副作用。方法2013年至2023年，190名女性纳入回顾性研究。其中，82例患者术后同步放化疗（CCRT）联合每周顺铂+ IMRT (45.0-50.4 Gy)，然后进行C-CT， 108例患者单独接受CCRT。以1:1的比例进行倾向评分匹配（PSM）。分析两组患者的临床参数、总生存期（OS）和无复发生存期（RFS）。结果中位随访时间为50.2个月。C-CT组4年OS率为88.7%，单纯cct组为87.9% （p = 0.886）。C-CT组的4年RFS为76.3%，cct组为80.5% （p = 0.289）。在有三个或更多淋巴结阳性的患者中，与仅ccrt组相比，C-CT与OS的显著改善相关（HR 0.14, 95% CI 0.02-0.88, p = 0.036），而RFS无显著差异（HR 0.80, 95% CI 0.27-2.32, p = 0.676）。然而，C-CT组3/4级血液学毒性发生率更高（16.8% vs. 1.7%, p = 0.009）。我们的研究发现，除了那些有三个或更多淋巴结阳性的早期宫颈癌HRFs患者外，C-CT顺铂化疗联合IMRT并没有比单独CCRT带来额外的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.