This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Eifel, P. J. Articles by Mutch, D. G. Search for Related Content PubMed PubMed Citation Articles by Eifel, P. J. Articles by Mutch, D. G.

Pelvic Irradiation With Concurrent Chemotherapy Versus Pelvic and Para-Aortic Irradiation for High-Risk Cervical Cancer: An Update of Radiation Therapy Oncology Group Trial (RTOG) 90-01

From the Departments of Radiation Oncology and Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX; Statistical Unit, Radiation Therapy Oncology Group, Philadelphia, PA; Mallinckrodt Institute of Radiology and Department of Gynecologic Oncology, Washington University School of Medicine, St Louis, MO; Department of Radiation Oncology, New York University, New York; and Department of Radiation Oncology, State University of New York Health Science Center, Brooklyn, NY

Address reprint requests to Patricia Eifel, MD, Department of Radiation Oncology, Unit 97, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030; e-mail: peifel{at}mdanderson.org

PURPOSE: To report mature results of a randomized trial that compared extended-field radiotherapy (EFRT) versus pelvic radiotherapy with concomitant fluorouracil and cisplatin (CTRT) in women with locoregionally advanced carcinomas of the uterine cervix.

PATIENTS AND METHODS: Four hundred three women with cervical cancer were randomly assigned to receive either EFRT or CTRT. Patients were eligible if they had stage IIB to IVA disease, stage IB to IIA disease with a tumor diameter 5 cm, or positive pelvic lymph nodes. Patients were stratified by stage and by method of lymph node evaluation.

RESULTS: The median follow-up time for 228 surviving patients was 6.6 years. The overall survival rate for patients treated with CTRT was significantly greater than that for patients treated with EFRT (67% v 41% at 8 years; P < .0001). There was an overall reduction in the risk of disease recurrence of 51% (95% CI, 36% to 66%) for patients who received CTRT. Patients with stage IB to IIB disease who received CTRT had better overall and disease-free survival than those treated with EFRT (P < .0001); 116 patients with stage III to IVA disease had better disease-free survival (P = .05) and a trend toward better overall survival (P = .07) if they were randomly assigned to CTRT. The rate of serious late complications of treatment was similar for the two treatment arms.

CONCLUSION: Mature analysis confirms that the addition of fluorouracil and cisplatin to radiotherapy significantly improved the survival rate of women with locally advanced cervical cancer without increasing the rate of late treatment-related side effects.

Supported by grant no. RTOG U10 CA21661 from the National Cancer Institute. The contents of this study are the responsibility solely of the authors and do not necessarily represent the official views of the National Cancer Institute.

Presented at the 44th Annual Meeting of the American Society of Therapeutic Radiology and Oncology, October 2002, New Orleans, LA.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

This article has been cited by other articles:

				J. Chen, O. K. Macdonald, and D. K. Gaffney Incidence, Mortality, and Prognostic Factors of Small Cell Carcinoma of the Cervix Obstet. Gynecol., June 1, 2008; 111(6): 1394 - 1402. [Abstract] [Full Text] [PDF]

				J. K. Schwarz, B. A. Siegel, F. Dehdashti, and P. W. Grigsby Association of Posttherapy Positron Emission Tomography With Tumor Response and Survival in Cervical Carcinoma JAMA, November 21, 2007; 298(19): 2289 - 2295. [Abstract] [Full Text] [PDF]

				B. J. Monk, K. S. Tewari, and W.-J. Koh Multimodality Therapy for Locally Advanced Cervical Carcinoma: State of the Art and Future Directions J. Clin. Oncol., July 10, 2007; 25(20): 2952 - 2965. [Abstract] [Full Text] [PDF]

				P. G. Rose, S. Ali, E. Watkins, J. T. Thigpen, G. Deppe, D. L. Clarke-Pearson, and S. Insalaco Long-Term Follow-Up of a Randomized Trial Comparing Concurrent Single Agent Cisplatin, Cisplatin-Based Combination Chemotherapy, or Hydroxyurea During Pelvic Irradiation for Locally Advanced Cervical Cancer: A Gynecologic Oncology Group Study J. Clin. Oncol., July 1, 2007; 25(19): 2804 - 2810. [Abstract] [Full Text] [PDF]

				P. J. Eifel Chemoradiotherapy for Cervical Cancer: What Next? J. Clin. Oncol., November 20, 2005; 23(33): 8277 - 8279. [Full Text] [PDF]

				R. Lanciano, A. Calkins, B. N. Bundy, G. Parham, J. A. Lucci III, D. H. Moore, B. J. Monk, and D. M. O'Connor Randomized Comparison of Weekly Cisplatin or Protracted Venous Infusion of Fluorouracil in Combination With Pelvic Radiation in Advanced Cervix Cancer: A Gynecologic Oncology Group Study J. Clin. Oncol., November 20, 2005; 23(33): 8289 - 8295. [Abstract] [Full Text] [PDF]

				C. Haie-Meder, B. Fervers, E. Fondrinier, M. Haugh, C. Lhomme, and J. P. Guastalla SOR guidelines for concomitant chemoradiotherapy for patients with uterine cervical cancers: evidence update bulletin 2004 Ann. Onc., July 1, 2005; 16(7): 1100 - 1108. [Abstract] [Full Text] [PDF]

				D. R. Aberle, C. Chiles, C. Gatsonis, B. J. Hillman, C. D. Johnson, B. L. McClennan, D. G. Mitchell, E. D. Pisano, M. D. Schnall, and A. G. Sorensen Imaging and Cancer: Research Strategy of the American College of Radiology Imaging Network Radiology, June 1, 2005; 235(3): 741 - 751. [Abstract] [Full Text] [PDF]