Long-Term Improvement in Treatment Outcome After Radiotherapy and Hyperthermia in Locoregionally Advanced Cervix Cancer: An Update of the Dutch Deep Hyperthermia Trial
- Department of Radiation Oncology, Hyperthermia Unit, Erasmus Medical Center Rotterdam, Daniel den Hoed Cancer Center, Rotterdam (Netherlands)
- Department of Radiotherapy, Academic Medical Center Amsterdam, Amsterdam (Netherlands)
- Department of Radiation Oncology, HagaZiekenhuis, Den Haag (Netherlands)
- Department of Radiation Oncology, Medisch Centrum Haaglanden, Den Haag (Netherlands)
- Department of Radiation Oncology, University Medical Center Sint Radboud, Nijmegen (Netherlands)
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands)
- Department of Radiation Oncology, Medisch Spectrum Twente, Enschede (Netherlands)
Purpose: The local failure rate in patients with locoregionally advanced cervical cancer is 41-72% after radiotherapy (RT) alone, whereas local control is a prerequisite for cure. The Dutch Deep Hyperthermia Trial showed that combining RT with hyperthermia (HT) improved 3-year local control rates of 41-61%, as we reported earlier. In this study, we evaluate long-term results of the Dutch Deep Hyperthermia Trial after 12 years of follow-up. Methods and Materials: From 1990 to 1996, a total of 114 women with locoregionally advanced cervical carcinoma were randomly assigned to RT or RT + HT. The RT was applied to a median total dose of 68 Gy. The HT was given once weekly. The primary end point was local control. Secondary end points were overall survival and late toxicity. Results: At the 12-year follow-up, local control remained better in the RT + HT group (37% vs. 56%; p = 0.01). Survival was persistently better after 12 years: 20% (RT) and 37% (RT + HT; p = 0.03). World Health Organization (WHO) performance status was a significant prognostic factor for local control. The WHO performance status, International Federation of Gynaecology and Obstetrics (FIGO) stage, and tumor diameter were significant for survival. The benefit of HT remained significant after correction for these factors. European Organization for Research and Treatment of Cancer Grade 3 or higher radiation-induced late toxicities were similar in both groups. Conclusions: For locoregionally advanced cervical cancer, the addition of HT to RT resulted in long-term major improvement in local control and survival without increasing late toxicity. This combined treatment should be considered for patients who are unfit to receive chemotherapy. For other patients, the optimal treatment strategy is the subject of ongoing research.
- OSTI ID:
- 21039841
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 70, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2007.07.2348; PII: S0360-3016(07)03705-4; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
Similar Records
Hyperthermia and Radiation Therapy in Locoregional Recurrent Breast Cancers: A Systematic Review and Meta-analysis
Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes