Concurrent cisplatin chemotherapy with intensity‐modulated radiotherapy followed by consolidation chemotherapy in early‐stage cervical cancer patients with high‐risk factors after radical hysterectomy
Abstract
Objectives
To evaluate the efficacy and toxicity of consolidation chemotherapy (C‐CT) following concurrent cisplatin chemotherapy combined with intensity‐modulated radiotherapy (IMRT) in patients with early‐stage cervical cancer who present high‐risk factors (HRFs).
Methods
Between 2013 and 2023, a total of 190 women were included in this retrospective study. Among these, 82 patients received postoperative concurrent chemoradiotherapy (CCRT) with weekly cisplatin and IMRT (45.0–50.4 Gy), followed by C‐CT, while 108 patients received CCRT alone. A propensity score matching (PSM) was performed with a ratio of 1:1. Clinical parameters, overall survival (OS), and relapse‐free survival (RFS) were analyzed for both groups.
Results
The median follow‐up duration was 50.2 months. The 4‐year OS rates were 88.7% in the C‐CT group and 87.9% in the CCRT‐only group (p = 0.886). The 4‐year RFS rates were 76.3% for the C‐CT group and 80.5% for the CCRT‐only group (p = 0.289). In patients with three or more positive lymph nodes, C‐CT was associated with significantly improved OS compared to the CCRT‐only group (HR 0.14, 95% CI 0.02–0.88, p = 0.036), while RFS showed no significant difference (HR 0.80, 95% CI 0.27–2.32, p = 0.676). However, the incidence of grade 3/4 hematologic toxicity was higher in the C‐CT group (16.8% vs. 1.7%, p = 0.009).
Conclusions
Our study found that C‐CT following concurrent cisplatin chemotherapy with IMRT did not confer additional benefits over CCRT alone in the majority of early‐stage cervical cancer patients with HRFs, except in those with three or more positive lymph nodes.