Comparison of chemoradiation with radiation as postoperative adjuvant therapy in cervical cancer patients with intermediate-risk factors.

AIMS: In cervical cancer patients with intermediate-risk factors, the optimal adjuvant therapy is still controversial. We retrospectively compared the treatment outcome of chemoradiation with that of radiation.
METHODS: From 1997 to 2005, 79 consecutive cervical cancer patients received postoperative adjuvant therapy indicated by intermediate-risk factors. Fifty-five women received chemoradiation and 24 women received radiation. Risk factors, recurrence-free survival (RFS), adverse events, and recurrence pattern were investigated and were compared between the chemoradiation and radiation groups. RFS was calculated by the Kaplan-Meier method and was compared by the log-rank test.
RESULTS: Risk factors were well-balanced between the two groups. Four patients recurred in the chemoradiation group and eight patients recurred in the radiation group. RFS rate of the chemoradiation group was significantly higher than that of the radiation group (P=0.01). Hematologic toxicity was more common in the chemoradiation group than in the radiation group (P<0.01). However, non-hematologic toxicity was similar between the two groups and most of the patients (97%) completed postoperative adjuvant therapy. Recurrence pattern was similar between the two groups.
CONCLUSION: In cervical cancer patients with intermediate-risk factors, chemoradiation was well-tolerated and more effective than radiation as a postoperative adjuvant therapy.