Clinical efficacy of concurrent chemoradiotherapy for cervical adenocarcinoma and salvage treatment of residual lesions

ABSTRACT

Objective:

To evaluate the clinical efficacy of concurrent chemoradiotherapy for cervical adenocarcinoma, and to analyze the treatment and evaluate the prognosis of patients with residual lesions after definitive radiotherapy.

Clinical data of 109 patients with locally advanced cervical adenocarcinoma treated from January 2005 to February 2016 were analyzed retrospectively. The prescription dose of external irradiation was 50.4 Gy, 28 fractions, and the point A dose of brachytherapy was 30-36 Gy, 5-7 fractions. Cisplatin or paclitaxel was used as concurrent chemotherapy regimen. Clinical efficacy was evaluated after concurrent chemoradiotherapy. Patients with clinical partial remission (PR) after treatment might receive salvage surgery and/or chemotherapy and/or radiotherapy. The survival analysis was performed with Kaplan Meier method.

The median follow-up period was 48 months, and the 3-year and 5-year overall survival rates were 74.1% and 58.5%, respectively. After concurrent chemoradiotherapy, 72 patients (66.1%) achieved clinical complete remission, and 31 patients (28.4%) obtained PR. After receiving salvage treatment, the 3-year overall survival rate and progression-free survival rate of PR patients were 53.1% and 40.5%, respectively. Only 4 patients (3.7%) and 2 patients (1.8%) had grade 3 or greater urinary and gastrointestinal toxicity after definitive treatment.

For patients with cervical adenocarcinoma who have clinical residual lesions after primary treatment, salvage treatment should be actively taken in order to improve survival outcomes.