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Explanation for the failure of neoadjuvant chemotherapy to improve outcomes after radiotherapy for locally advanced uterine cervical cancer from the standpoint of the tumor regression rate

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Abstract

Purpose

Treatment outcomes for patients with locally advanced cervical cancer are no better with neoadjuvant chemotherapy (NAC) combined with radiotherapy (RT) than with RT alone. We investigated the reason for this failure from the standpoint of the tumor regression rate (RR).

Materials and methods

A total of 48 patients with clinical stage IIB-IVA cervical squamous cell carcinoma were treated clinically with cisplatin-based NAC plus RT (n = 15) or RT alone (n = 33). The RR was defined as the slope of a tumor shrinkage curve derived with magnetic resonance images. The local control rate (LCR) and disease-free rate (DFR) were estimated by clinical stage (IIB vs. III-IVA), pretreatment volume (≤ median vs. > median), lymph node status (negative vs. positive), treatment type, overall treatment time (≤8 weeks vs. >8 weeks), and RR (≤ median vs. > median) using univariate and multivariate analyses.

Results

RR during NAC or during NAC and RT (n = 15) was not significantly higher than RR by RT alone (n = 33). Low RR and positive nodal status were significantly powerful prognostic factors for both the LCR and DFR, whereas the others were not.

Conclusion

Although effective in reducing tumor volume prior to RT, NAC showed no overall effect in increasing the RR, which was shown to be the most powerful prognostic factor.

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Authors and Affiliations

  1. Department of Radiation Oncology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, 305-8575, Japan

    Kiyoshi Ohara, Kayoko Ohnishi, Keiko Nemoto, Takayuki Hashimoto, Nobuyoshi Fukumitsu, Masaharu Hata, Shinji Sugahara, Koichi Tokuuye & Yasuyuki Akine

  2. Department of Obstetrics and Gynecology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan

    Hajime Tsunoda & Hiroyuki Yoshikawa

  3. Department of Diagnostic Radiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan

    Yumiko Oishi Tanaka

Authors
  1. Kiyoshi Ohara
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  2. Hajime Tsunoda
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  3. Yumiko Oishi Tanaka
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  4. Kayoko Ohnishi
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  5. Keiko Nemoto
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  6. Takayuki Hashimoto
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  7. Nobuyoshi Fukumitsu
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  8. Masaharu Hata
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  9. Shinji Sugahara
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  10. Koichi Tokuuye
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  11. Hiroyuki Yoshikawa
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  12. Yasuyuki Akine
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Corresponding author

Correspondence to Kiyoshi Ohara.

Additional information

Part of this study was presented at the 17th International Congress on Anti-Cancer Treatment (January 30–February 2, 2006, Paris) and the 65th Annual Meeting of the Japan Radiological Society (April 7–9, 2006, Yokohama)

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Ohara, K., Tsunoda, H., Tanaka, Y. et al. Explanation for the failure of neoadjuvant chemotherapy to improve outcomes after radiotherapy for locally advanced uterine cervical cancer from the standpoint of the tumor regression rate. Radiat Med 25, 53–59 (2007). https://doi.org/10.1007/s11604-006-0101-7

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  • DOI: https://doi.org/10.1007/s11604-006-0101-7

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