OBJECTIVE: To evaluate the prognostic significance of adjuvant concurrent chemoradiotherapy-induced neutropenia with survival in patients with squamous cell carcinoma of the uterine cervix. METHODS: Data from 107 patients with stage IB-IIB cervical cancer were retrospectively analyzed. The median follow-up was 37.5 (4.2-72.7) months. All patients had received radical surgery, including pelvic lymphadenectomy, followed by paclitaxel plus carboplatin-based concurrent chemoradiotherapy. Relative neutropenia, defined as an absolute neutrophil count <1,000/mm(3) at the concurrent chemoradiotherapy cycle nadir, correlated to the pathologic findings and survival outcomes. RESULTS: Sixty-six patients experienced neutropenia at least once during concurrent chemoradiotherapy, and demonstrated marginal improvement in disease-free survival (p=0.055), although not in overall survival. By subgroup analyses, the gain of disease free survival mainly originated from the node metastasis subgroup (p=0.033). Treatment-induced neutropenia proved to be the only significant independent factor for recurrence in cervical cancer (p=0.042) by multivariate analysis. CONCLUSION: Concurrent chemoradiotherapy-induced neutropenia may be a prognostic factor of recurrence in patients with cervical cancer. Individualized dose titration of the tolerable myelosuppression might be beneficial.
OBJECTIVE: To evaluate the prognostic significance of adjuvant concurrent chemoradiotherapy-induced neutropenia with survival in patients with squamous cell carcinoma of the uterine cervix. METHODS: Data from 107 patients with stage IB-IIB cervical cancer were retrospectively analyzed. The median follow-up was 37.5 (4.2-72.7) months. All patients had received radical surgery, including pelvic lymphadenectomy, followed by paclitaxel plus carboplatin-based concurrent chemoradiotherapy. Relative neutropenia, defined as an absolute neutrophil count <1,000/mm(3) at the concurrent chemoradiotherapy cycle nadir, correlated to the pathologic findings and survival outcomes. RESULTS: Sixty-six patients experienced neutropenia at least once during concurrent chemoradiotherapy, and demonstrated marginal improvement in disease-free survival (p=0.055), although not in overall survival. By subgroup analyses, the gain of disease free survival mainly originated from the node metastasis subgroup (p=0.033). Treatment-induced neutropenia proved to be the only significant independent factor for recurrence in cervical cancer (p=0.042) by multivariate analysis. CONCLUSION: Concurrent chemoradiotherapy-induced neutropenia may be a prognostic factor of recurrence in patients with cervical cancer. Individualized dose titration of the tolerable myelosuppression might be beneficial.
Entities:
Keywords:
Chemoradiotherapy; Neutropenia; Survival; Uterine cervical cancer
Authors: Emer O Hanrahan; Kristine Broglio; Deborah Frye; Aman U Buzdar; Richard L Theriault; Vicente Valero; Daniel J Booser; Sonja E Singletary; Eric A Strom; James L Gajewski; Richard E Champlin; Gabriel N Hortobagyi Journal: Cancer Date: 2006-06-01 Impact factor: 6.860
Authors: Jeffrey Crawford; Betsy Althaus; James Armitage; Lodovico Balducci; Charles Bennett; Douglas W Blayney; Spero R Cataland; David C Dale; George D Demetri; Harry P Erba; James Foran; Alison G Freifeld; Mark L Heaney; Sally Htoy; Dwight D Kloth; Gary H Lyman; Wells A Messersmith; Laura Boehnke Michaud; Sarah C Miyata; Amy Robbins; Martin S Tallman; Saroj Vadhan-Raj; Peter Westervelt; Michael K Wong Journal: J Natl Compr Canc Netw Date: 2007-02 Impact factor: 11.908
Authors: W A Peters; P Y Liu; R J Barrett; R J Stock; B J Monk; J S Berek; L Souhami; P Grigsby; W Gordon; D S Alberts Journal: J Clin Oncol Date: 2000-04 Impact factor: 44.544
Authors: Rodney P Rocconi; Kellie S Matthews; Meredith K Kemper; Kelly E Hoskins; Mack N Barnes Journal: Gynecol Oncol Date: 2007-11-19 Impact factor: 5.482
Authors: Marcus Schlemmer; Clemens-Martin Wendtner; Martin Falk; Sultan Abdel-Rahman; Thomas Licht; Jens Baumert; Christian Straka; Marcus Hentrich; Christoph Salat; Wolfgang Hiddemann; Rolf-Dieter Issels Journal: Oncology Date: 2007-03-05 Impact factor: 2.935
Authors: Hak Jae Kim; Jin Ho Kim; Sung Whan Ha; Hong-Gyun Wu; Jin Hwa Choi; Kyung-Mi Lee; Seung Wan Kang Journal: J Gynecol Oncol Date: 2012-04-03 Impact factor: 4.401