Concurrent chemoradiation for cervical cancer: results of five randomized trials

Cervical cancer is the second most common cancer among women's in Bosnia and Herzegovina. Most of these women's in the time of diagnosis are with advanced disease. In the 1999 NCI issued a clinical alert, recommending that chemo radiation should be implemented as new treatment for these patients.

To determine a survival, loco regional control and toxicity in patients with cervical carcinoma treated in Institute o Oncology from 2000-2006.

This is retrospective study. Data of five hundred and fourteen patients diagnosed as cervical cancer FIGO stage Ib, -IVb and presented in our Institute, were analyzed. We treated 345 with combined chemo radiotherapy, 162 with radiotherapy alone and 7 patients with symptomatic therapy. In the follow up 134 patients were lost, so 373 patients were analyzed for survival, loco regional control and toxicity. Subgroup of 148 patients with advanced disease and grade of tumor unknown and 136 patients with known grade of tumor were compared for time to local progression, time to distant metastasis and time to death.

Median age in this group of patients was 52 (27-85). Of 514 patients 492 were treated with curative intentions and 15 got palliative treatment. All treated patients finished their planed therapy. Follow up was from 6-78 months, median 28 months. From 373 patients who were analyzed 65 died, progressions were observed in 77 patients. Acute toxicity G3/G4 experienced 109 patients, and late toxicity G3/G4 8 patients. Patients with advanced disease and unknown grade of tumor cells had significantly shorter time to local progression, distant metastasis and death.

The combined therapy for cervical cancer is the safe and good tolerated treatment. In the group of patients with advanced disease we observed 81% overall survival, 55.9% disease free survival for median follow up of 28 months. In the group of patients with early disease we observed 90% overall survival, and 78.8% disease free survival for median follow up of 28 months. There were no deaths caused by treatment.