Publication:
Why not de-intensification for uterine cervical cancer?

Issued Date

2021-10-01

Resource Type

Article

ISSN

10956859
00908258

DOI

10.1016/j.ygyno.2021.07.021

Other identifier(s)

2-s2.0-85110761151

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Gynecologic Oncology. Vol.163, No.1 (2021), 105-109

Suggested Citation

Naoya Murakami, Ken Ando, Masumi Murata, Kazutoshi Murata, Tatsuya Ohno, Tomomi Aoshika, Shingo Kato, Noriyuki Okonogi, Anneyuko I. Saito, Joo Young Kim, Yasuko Kumai, Yasuo Yoshioka, Shuhei Sekii, Kayoko Tsujino, Chairat Lowanichkiattikul, Poompis Pattaranutaporn, Yuko Kaneyasu, Tomio Nakagawa, Miho Watanabe, Takashi Uno, Rei Umezawa, Keiichi Jingu, Ayae Kanemoto, Masaru Wakatsuki, Katsuyuki Shirai, Hiroshi Igaki, Jun Itami Why not de-intensification for uterine cervical cancer?. Gynecologic Oncology. Vol.163, No.1 (2021), 105-109. doi:10.1016/j.ygyno.2021.07.021 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77829

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Title

Why not de-intensification for uterine cervical cancer?

Author(s)

Naoya Murakami
 Ken Ando
 Masumi Murata
 Kazutoshi Murata
 Tatsuya Ohno
 Tomomi Aoshika
 Shingo Kato
 Noriyuki Okonogi
 Anneyuko I. Saito
 Joo Young Kim
 Yasuko Kumai
 Yasuo Yoshioka
 Shuhei Sekii
 Kayoko Tsujino
 Chairat Lowanichkiattikul
 Poompis Pattaranutaporn
 Yuko Kaneyasu
 Tomio Nakagawa
 Miho Watanabe
 Takashi Uno
 Rei Umezawa
 Keiichi Jingu
 Ayae Kanemoto
 Masaru Wakatsuki
 Katsuyuki Shirai
 Hiroshi Igaki
 Jun Itami

Other Contributor(s)

Hyogo Cancer Center
 National Hospital Organization Fukuyama Medical Center
 Graduate School of Medicine
 Saitama Medical University International Medical Center
 Graduate School of Medicine
 QST Hospital
 Gunma Prefectural Cancer Center
 Jichi Medical University
 National Cancer Center, Gyeonggi
 Cancer Institute Hospital of Japan Foundation for Cancer Research
 National Cancer Center Hospital
 Faculty of Medicine Ramathibodi Hospital, Mahidol University
 Niigata Cancer Center Hospital
 Juntendo University School of Medicine
 Chiba University Hospital
 Kita-Harima Medical Center

Abstract

Objective: The majority of uterine cervical cancer is known to be related to human papillomavirus (HPV), and HPV-related tumors are known to be radio-sensitive. In the management of HPV-related oropharyngeal cancer, de-intensification of treatment has been attempted; however, no such attempt is performed in the management of cervical cancer. The aim of this study was to identify a group of patients who can safely be treated by de-escalated treatment intensity. Methods: From the Asian international multi-institutional retrospective study involving 13 Japanese, one Thailand, and one Korean institutions based on 469 patients, squamous cell carcinoma (Scc), tumor reduction ratio ≥29%, tumor size before brachytherapy ≤4 cm, and total treatment time (TTT) <9 weeks were identified as factors having an influence on local control. Based on these findings, low-risk patients having these four factors were extracted, and treatment outcomes categorized in 10 Gy increment of CTVHR D90 were compared. Results: Among 469 patients, 162 patients (34.5%) met the criteria of low-risk group, and 63, 41, 43, and 15 patients were categorized in CTVHR D90 50–60 Gy, 60–70 Gy, 70–80 Gy, and >80 Gy, respectively. While 4-y progression-free survival ranged from 66 to 80%, 4-y local control was consistently over 90% in every dose group. Rectum and bladder D2cc and incidence of late adverse events decreased as CTVHR D90 decreased. Conclusions: The low-risk patients achieved favorable local control with CTVHR D90 <80 Gy. A personalized treatment strategy based on tumor response could also be adopted for cervical cancer.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/77829

Collections

Scopus 2021