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Shitara K, Fleitas T, Kawakami H, Curigliano G, Narita Y, Wang F, Wardhani SO, Basade M, Rha SY, Wan Zamaniah WI, Sacdalan DL, Ng M, Yeh KH, Sunpaweravong P, Sirachainan E, Chen MH, Yong WP, Peneyra JL, Ibtisam MN, Lee KW, Krishna V, Pribadi RR, Li J, Lui A, Yoshino T, Baba E, Nakayama I, Pentheroudakis G, Shoji H, Cervantes A, Ishioka C, Smyth E. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with gastric cancer. ESMO Open 2024; 9:102226. [PMID: 38458658 PMCID: PMC10937212 DOI: 10.1016/j.esmoop.2023.102226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 03/10/2024] Open
Abstract
The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with gastric cancer (GC), published in late 2022 and the updated ESMO Gastric Cancer Living Guideline published in July 2023, were adapted in August 2023, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with GC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with GC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), coordinated by ESMO and the Japanese Society of Medical Oncology (JSMO). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different Asian regions represented by the 10 oncological societies. The latter are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with GC across the different regions of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices, molecular profiling and age and stage at presentation. Attention is drawn to the disparity in the drug approvals and reimbursement strategies, between the different regions of Asia.
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Affiliation(s)
- K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
| | - T Fleitas
- Department of Medical Oncology, Hospital Clínico Universitario de Valencia, INCLIVA Biomedical Research Institute, Valencia, Spain
| | - H Kawakami
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - G Curigliano
- Istituto Europeo di Oncologia, IRCCS, Milan; Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy
| | - Y Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - F Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Mainland China
| | - S O Wardhani
- Department of Internal Medicine Division of Medical Hematology-Oncology, Brawijaya University, Dr. Saiful Anwar General Hospital Malang, East Java, Indonesia
| | - M Basade
- Department of Medical Oncology, Jaslok Hospital and Breach Candy Hospital, Mumbai, India
| | - S Y Rha
- Department of Internal Medicine, Yonsei University College of Medicine, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
| | - W I Wan Zamaniah
- Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - D L Sacdalan
- Division of Medical Oncology, Department of Medicine, University of the Philippines, Manila, The Philippines
| | - M Ng
- Department of GI Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - K H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - P Sunpaweravong
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla
| | - E Sirachainan
- Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - M-H Chen
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - W P Yong
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - J L Peneyra
- St. Peregrine Oncology Unit, San Juan de Dios Hospital, Pasay City, The Philippines
| | - M N Ibtisam
- Institute of Radiotherapy and Oncology, General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - K-W Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - V Krishna
- Department of Medical Oncology, AIG Hospital, Hyderabad, India
| | - R R Pribadi
- Division of Gastroenterology, Pancreatobiliary Oncology and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - J Li
- Department of Oncology, University of Tongji, Shanghai East Hospital, Shanghai, Mainland China
| | - A Lui
- Section of Medical Oncology, Department of Internal Medicine, Southern Philippines Medical Center ESM, Davao City, The Philippines
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - E Baba
- Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - I Nakayama
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - H Shoji
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - A Cervantes
- Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - C Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - E Smyth
- Department of Oncology, Oxford University Hospital NHS Foundation Trust, Oxford, UK
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Keam B, Machiels JP, Kim HR, Licitra L, Golusinski W, Gregoire V, Lee YG, Belka C, Guo Y, Rajappa SJ, Tahara M, Azrif M, Ang MK, Yang MH, Wang CH, Ng QS, Wan Zamaniah WI, Kiyota N, Babu S, Yang K, Curigliano G, Peters S, Kim TW, Yoshino T, Pentheroudakis G. Pan-Asian adaptation of the EHNS-ESMO-ESTRO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with squamous cell carcinoma of the head and neck. ESMO Open 2021; 6:100309. [PMID: 34844180 PMCID: PMC8710460 DOI: 10.1016/j.esmoop.2021.100309] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of squamous cell carcinoma (SCC) of the oral cavity, larynx, oropharynx and hypopharynx was published in 2020. It was therefore decided by both the ESMO and the Korean Society of Medical Oncology (KSMO) to convene a special, virtual guidelines meeting in July 2021 to adapt the ESMO 2020 guidelines to consider the potential ethnic differences associated with the treatment of SCCs of the head and neck (SCCHN) in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with SCCHN (excluding nasopharyngeal carcinomas) representing the oncological societies of Korea (KSMO), China (CSCO), India (ISMPO), Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of the current treatment practices and drug access restrictions in the different Asian countries. The latter was discussed when appropriate. This manuscript provides a series of expert recommendations (Clinical Practice Guidelines) which can be used to provide guidance to health care providers and clinicians for the optimisation of the diagnosis, treatment and management of patients with SCC of the oral cavity, larynx, oropharynx and hypopharynx across Asia.
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Affiliation(s)
- B Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
| | - J-P Machiels
- Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - H R Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - L Licitra
- Head and Neck Cancer Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, Milan, Italy
| | - W Golusinski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - V Gregoire
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Y G Lee
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - C Belka
- Department of Radiation Oncology, LMU Hospital, Munich, Germany
| | - Y Guo
- Department of Medical Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - S J Rajappa
- Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, India
| | - M Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - M Azrif
- Clinical Oncology, Prince Court Medical Centre, Kuala Lumpur, Malaysia
| | - M K Ang
- Department of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - M-H Yang
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - C-H Wang
- Division of Hemato-oncology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Q S Ng
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - W I Wan Zamaniah
- Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N Kiyota
- Oncology/Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
| | - S Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India
| | - K Yang
- Department of Clinical Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - T W Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center East, Chiba, Japan
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Muro K, Lordick F, Tsushima T, Pentheroudakis G, Baba E, Lu Z, Cho BC, Nor IM, Ng M, Chen LT, Kato K, Li J, Ryu MH, Zamaniah WIW, Yong WP, Yeh KH, Nakajima TE, Shitara K, Kawakami H, Narita Y, Yoshino T, Van Cutsem E, Martinelli E, Smyth EC, Arnold D, Minami H, Tabernero J, Douillard JY. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with metastatic oesophageal cancer: a JSMO-ESMO initiative endorsed by CSCO, KSMO, MOS, SSO and TOS. Ann Oncol 2019; 30:34-43. [PMID: 30475943 DOI: 10.1093/annonc/mdy498] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of oesophageal cancer was published in 2016, and covered the management and treatment of local/locoregional disease, limited disease, locally advanced disease and the management of advanced/metastatic disease. At the ESMO Asia Meeting in November 2017 it was decided by both ESMO and the Japanese Society of Medical Oncology (JSMO) to convene a special guidelines meeting immediately after the JSMO Annual Meeting in 2018. The aim was to adapt the ESMO 2016 guidelines to take into account the ethnic differences associated with the treatment of metastatic oesophageal cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with metastatic oesophageal cancer representing the oncological societies of Japan (JSMO), China (CSCO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and was independent of both the current treatment practices and the drug availability and reimbursement situations in the individual participating Asian countries.
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Affiliation(s)
- K Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
| | - F Lordick
- University Cancer Center Leipzig, Leipzig; 1st Department of Medicine (Hematology and Medical Oncology), University Hospital Leipzig, Leipzig, Germany
| | - T Tsushima
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - E Baba
- Department of Comprehensive Clinical Oncology, Kyushu University, Fukuoka, Japan
| | - Z Lu
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - I M Nor
- Department of Radiotherapy & Oncology, General Hospital, Kuala Lumpur, Malaysia
| | - M Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - L-T Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - K Kato
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - J Li
- Department of Oncology, Tongji University affiliated East Hospital, Shanghai, China
| | - M-H Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - W I Wan Zamaniah
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - W-P Yong
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei; National Taiwan University Cancer Center, National Taiwan University College of Medicine, Taipei, Taiwan
| | - T E Nakajima
- Department of Clinical Oncology, School of Medicine, St. Marianna University, Kawasaki
| | - K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa
| | - H Kawakami
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Y Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa
| | - E Van Cutsem
- Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
| | - E Martinelli
- Department of Experimental Medicine - Medical Oncology, Università degli Studi della Campania L Vanvitelli, Napoli, Italy
| | - E C Smyth
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - D Arnold
- Asklepios Tumorzentrum Hamburg, Asklepios Klinik Altona, Hamburg, Germany
| | - H Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - J Tabernero
- Medical Oncology Department, Vall d' Hebron University Hospital, Vall d'Hebron Institute of Oncology (V.H.I.O.), Barcelona, Spain
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Muro K, Van Cutsem E, Narita Y, Pentheroudakis G, Baba E, Li J, Ryu MH, Zamaniah WIW, Yong WP, Yeh KH, Kato K, Lu Z, Cho BC, Nor IM, Ng M, Chen LT, Nakajima TE, Shitara K, Kawakami H, Tsushima T, Yoshino T, Lordick F, Martinelli E, Smyth EC, Arnold D, Minami H, Tabernero J, Douillard JY. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with metastatic gastric cancer: a JSMO-ESMO initiative endorsed by CSCO, KSMO, MOS, SSO and TOS. Ann Oncol 2019; 30:19-33. [PMID: 30475956 DOI: 10.1093/annonc/mdy502] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of gastric cancer (GC) was published in 2016, and covered the management and treatment of local, locoregional, locally advanced and metastatic disease. At the ESMO Asia Meeting in November 2017 it was decided by both ESMO and The Japanese Society of Medical Oncology (JSMO) to convene a special guidelines meeting immediately after the JSMO Annual Meeting in 2018. The aim was to adapt the ESMO 2016 guidelines to take into account the ethnic differences associated with the treatment of metastatic GC in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with metastatic GC representing the oncological societies of Japan (JSMO), China (CSCO), Korea (KSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence and was independent of both the current treatment practices and the drug availability and reimbursement situations in the individual participating Asian countries.
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Affiliation(s)
- K Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
| | - E Van Cutsem
- Digestive Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Y Narita
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - E Baba
- Department of Comprehensive Clinical Oncology, Kyushu University, Fukuoka, Japan
| | - J Li
- Department of Oncology, Tongji University affiliated East Hospital, Shanghai, China
| | - M-H Ryu
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - W I Wan Zamaniah
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, c
| | - W-P Yong
- Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei; National Taiwan University Cancer Center, National Taiwan University College of Medicine, Taipei, Taiwan
| | - K Kato
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Z Lu
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - I M Nor
- Department of Radiotherapy & Oncology, General Hospital, Kuala Lumpur, Malaysia
| | - M Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - L-T Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - T E Nakajima
- Department of Clinical Oncology, School of Medicine, St. Marianna University, Kawasaki
| | - K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa
| | - H Kawakami
- Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka
| | - T Tsushima
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa
| | - F Lordick
- University Cancer Centre Leipzig, Leipzig; 1st Department of Medicine (Hematology and Medical Oncology), University Hospital Leipzig, Leipzig, Germany
| | - E Martinelli
- Department of Precision Medicine - Medical Oncology, Università degli Studi della Campania L Vanvitelli, Napoli, Italy
| | - E C Smyth
- Department of Oncology, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - D Arnold
- Asklepios Tumorzentrum Hamburg, Asklepios Klinik Altona, Hamburg, Germany
| | - H Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - J Tabernero
- Medical Oncology Department, Vall d' Hebron University Hospital, Vall d'Hebron Institute of Oncology (V.H.I.O.), Barcelona, Spain
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Zamaniah WIW, Mastura MY, Phua CE, Adlinda A, Marniza S, Rozita AM. Definitive concurrent chemoradiotherapy in cervical cancer--a University of Malaya Medical Centre experience. Asian Pac J Cancer Prev 2014; 15:8987-92. [PMID: 25374241 DOI: 10.7314/apjcp.2014.15.20.8987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The efficacy of concurrent chemoradiotherapy in the treatment of locally advanced cervical cancer is well established. We aimed to investigate the long-term efficacy of definitive concurrent chemoradiotherapy for cervical cancer in the University of Malaya Medical Centre. MATERIALS AND METHODS A cohort of 60 patients with FIGO stage IB2-IVA cervical cancer who were treated with definitive concurrent chemoradiotherapy with cisplatin followed by intracavitary brachytherapy or external beam radiotherapy (EBRT) boost between November 2001 and May 2008 were analysed. Patients were initially treated with weekly intravenous cisplatin (40 mg/m2) concurrent with daily EBRT to pelvis of 45-50 Gy followed by low dose rate brachytherapy or EBRT boost to tumour. Local control rate, progression free survival, overall survival and treatment related toxicities graded by the RTOG criteria were evaluated. RESULTS The mean age was 56. At the median follow-up of 72 months, the estimated 5-year progression-free survival (PFS) (median PFS 39 months) and the 5-year overall survival (OS) (median OS 51 months) were 48% and 50% respectively. The 5-year local control rate was 67.3%. Grade 3-4 late gastrointestinal and genitourinary toxicity occurred in 9.3% of patients. CONCLUSIONS The 5-year PFS and the 5-year OS in this cohort were lower than in other institutions. More advanced stage at presentation, longer overall treatment time (OTT) of more than fifty-six days and lower total dose to point A were the potential factors contributing to a lower survival.
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Affiliation(s)
- W I Wan Zamaniah
- Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia E-mail :
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