Abstract
Purpose: This study ascertains the benefit and detriment of cis-platinum-based regimes for advanced cervical cancer using standard response parameters as well as a methodology to separate potential effects of radiosensitization and effects of control of occult systemic metastases. Materials and Methods: In addition to conventional response criteria used to analyze three recently published randomized studies, the efficacy of neoadjuvant chemotherapy is measured with a statistical model to calculate potential improvement in survival offered by perfect local and distant control. Results: Neoadjuvant chemotherapy either did not affect or it impaired survival in the three trials. Evidence of altered failure patterns was obtained. In particular, local control was compromised by neoadjuvant chemotherapy. Conclusion: Failure patterns are altered by treatment as well as by standard prognostic factors. Neoadjuvant chemotherapy may decrease survival. Possible reasons include the limited efficacy of cis-platinum alone and in combination with other therapeutic agents, accelerated repopulation caused by neoadjuvant therapy, delay in initiation of radiotherapy by neoadjuvant chemotherapy, low statistical power of published studies, and tumor heterogeneity. Curative modalities such as surgery and radiotherapy must not be compromised by neoadjuvant chemotherapy.
| Original language | English |
|---|---|
| Pages (from-to) | 975-979 |
| Number of pages | 5 |
| Journal | International journal of radiation oncology, biology, physics |
| Volume | 27 |
| Issue number | 4 |
| DOIs | |
| State | Published - Nov 15 1993 |
| Externally published | Yes |
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Keywords
- Accelerated repopulation
- Cervix cancer
- Cis-platinum
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Radiation
Cite this
On the lack of demonstrated clinical benefit of neoadjuvant cisplatinum therapy for cervical cancer. / Potish, Roger A.; Twiggs, Leo B.
In: International journal of radiation oncology, biology, physics, Vol. 27, No. 4, 15.11.1993, p. 975-979.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - On the lack of demonstrated clinical benefit of neoadjuvant cisplatinum therapy for cervical cancer
AU - Potish, Roger A.
AU - Twiggs, Leo B.
PY - 1993/11/15
Y1 - 1993/11/15
N2 - Purpose: This study ascertains the benefit and detriment of cis-platinum-based regimes for advanced cervical cancer using standard response parameters as well as a methodology to separate potential effects of radiosensitization and effects of control of occult systemic metastases. Materials and Methods: In addition to conventional response criteria used to analyze three recently published randomized studies, the efficacy of neoadjuvant chemotherapy is measured with a statistical model to calculate potential improvement in survival offered by perfect local and distant control. Results: Neoadjuvant chemotherapy either did not affect or it impaired survival in the three trials. Evidence of altered failure patterns was obtained. In particular, local control was compromised by neoadjuvant chemotherapy. Conclusion: Failure patterns are altered by treatment as well as by standard prognostic factors. Neoadjuvant chemotherapy may decrease survival. Possible reasons include the limited efficacy of cis-platinum alone and in combination with other therapeutic agents, accelerated repopulation caused by neoadjuvant therapy, delay in initiation of radiotherapy by neoadjuvant chemotherapy, low statistical power of published studies, and tumor heterogeneity. Curative modalities such as surgery and radiotherapy must not be compromised by neoadjuvant chemotherapy.
AB - Purpose: This study ascertains the benefit and detriment of cis-platinum-based regimes for advanced cervical cancer using standard response parameters as well as a methodology to separate potential effects of radiosensitization and effects of control of occult systemic metastases. Materials and Methods: In addition to conventional response criteria used to analyze three recently published randomized studies, the efficacy of neoadjuvant chemotherapy is measured with a statistical model to calculate potential improvement in survival offered by perfect local and distant control. Results: Neoadjuvant chemotherapy either did not affect or it impaired survival in the three trials. Evidence of altered failure patterns was obtained. In particular, local control was compromised by neoadjuvant chemotherapy. Conclusion: Failure patterns are altered by treatment as well as by standard prognostic factors. Neoadjuvant chemotherapy may decrease survival. Possible reasons include the limited efficacy of cis-platinum alone and in combination with other therapeutic agents, accelerated repopulation caused by neoadjuvant therapy, delay in initiation of radiotherapy by neoadjuvant chemotherapy, low statistical power of published studies, and tumor heterogeneity. Curative modalities such as surgery and radiotherapy must not be compromised by neoadjuvant chemotherapy.
KW - Accelerated repopulation
KW - Cervix cancer
KW - Cis-platinum
UR - http://www.scopus.com/inward/record.url?scp=0027440675&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027440675&partnerID=8YFLogxK
U2 - 10.1016/0360-3016(93)90477-D
DO - 10.1016/0360-3016(93)90477-D
M3 - Article
C2 - 8244832
AN - SCOPUS:0027440675
VL - 27
SP - 975
EP - 979
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
SN - 0360-3016
IS - 4
ER -