Pattern of primary and postoperative adjuvant concurrent chemoradiotherapy for treatment of uterine cervical cancer in Korea: Results of a multicenter retrospective study

Abstract

Objective: The aim of this retrospective study was to analyze and to compare the treatment outcomes of various concurrent chemoradiotherapy (CCRT) regimens for uterine cervical cancer during the past 10 years in the Republic of Korea.

Methods: Between January 1997 and December 2006 the medical records of 1,827 stage Ib-IVa cervical cancer patients from 23 institutions in Korea were retrospectively reviewed and analyzed. Of these 1,826 patients, 1,577 had complete medical records and were enrolled in the study. Patients were divided into two groups: group 1 received primary CCRT without surgery; and group 2 received adjuvant CCRT after radical hysterectomy. The survival differences between the different CCRT regimens (weekly cisplatin, monthly 5-FU+cisplatin, and monthly paclitaxel+cisplatin) were also analyzed.

Results: The median age was 54 years (range, 16-99 years). There were 1,020 patients in group 1 and 557 patients in group 2. The majority of patients in group 1 had regionally advanced stage disease (IIb-IVa), while the majority of patients in group 2 had early stage disease (Ib-IIa). In group 1, the disease-free survival (DFS) was longer in those patients who received platinum-based chemotherapy (weekly cisplatin and cisplatin+5-FU) compared to those who received paclitaxel, but there was no statistical difference in the overall survival (OS). In contrast, survival of group 2 patients was improved by the paclitaxel regimen, but without a significant difference. Significantly increased toxicities were observed in patients treated with monthly cisplatin/5-FU and paclitaxel, but the toxicities were easily managed.

Conclusion: CCRT is an effective mode of therapy for cervical cancer in Korea. Further study confirming the efficacy of various CCRT regimens is necessary.