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 Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pearcey, R. Articles by Mackillop, W. J. Search for Related Content PubMed PubMed Citation Articles by Pearcey, R. Articles by Mackillop, W. J. Social Bookmarking                            What's this?

Impact of Adoption of Chemoradiotherapy on the Outcome of Cervical Cancer in Ontario: Results of a Population-Based Cohort Study

Robert Pearcey, Qun Miao, Weidong Kong, Jina Zhang-Salomons, William J. Mackillop

From the Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Kingston, Ontario; and the Cross Cancer Institute, Edmonton, Alberta, Canada

Address reprint requests to W.J. Mackillop, MD, Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, 10 Stuart St, Level 2, Kingston, Ontario K7L 3N6 Canada; e-mail: william.mackillop{at}krcc.on.ca

Purpose To describe the adoption of concurrent cisplatin-based chemoradiotherapy (C-CRT), and to evaluate its impact on the outcome of cervical cancer in Ontario.

Methods We used a population-based cancer registry to identify the 4,069 patients with invasive carcinoma of the cervix diagnosed in Ontario between 1992 and 2001. We linked electronic records of treatment to the registry. We described time trends in the use of C-CRT, and we compared survival before and after widespread adoption of C-CRT.

Results Over the study period, the proportion of patients treated with primary radical radiotherapy (RT) remained constant at approximately 42%. Between 1992 and 1998, less than 10% of RT cases received chemotherapy. Early in 1999, there was rapid adoption of C-CRT. Between 1999 and 2001, more than 60% of RT cases received C-CRT. There was a contemporaneous increase in overall 3-year survival from 71.1% in the 1995 to 1998 cohort to 75.9% in the 1999 to 2001 cohort (P = .03). There was no change in survival in patients treated with surgery alone. However, there was a significant increase in 3-year survival from 58.6% in the 1995 to 1998 cohort to 69.8% in the 1999 to 2001 cohort (P < .01) in the subpopulation of patients treated with primary RT ± chemotherapy.

Conclusion The adoption of C-CRT was associated with a significant improvement in overall survival of cervical cancer at the population level. The magnitude of the benefit of C-CRT in the general population was consistent with the results of the relevant clinical trials.

Supported by the Ontario Cancer Research Network (W.J.M.).

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				C. A. Banuelos, J. P. Banath, J.-Y. Kim, C. Aquino-Parsons, and P. L. Olive {gamma}H2AX Expression in Tumors Exposed to Cisplatin and Fractionated Irradiation Clin. Cancer Res., May 15, 2009; 15(10): 3344 - 3353. [Abstract] [Full Text] [PDF]

				Chemoradiotherapy for Cervical Cancer Meta-Analysi Reducing Uncertainties About the Effects of Chemoradiotherapy for Cervical Cancer: A Systematic Review and Meta-Analysis of Individual Patient Data From 18 Randomized Trials J. Clin. Oncol., December 10, 2008; 26(35): 5802 - 5812. [Abstract] [Full Text] [PDF]

				C. M. Booth and W. J. Mackillop Translating New Medical Therapies Into Societal Benefit: The Role of Population-Based Outcome Studies JAMA, November 12, 2008; 300(18): 2177 - 2179. [Full Text] [PDF]