Long-Term Results of Concurrent Chemoradiotherapy Combined with Anti-EGFR Monoclonal Antibody Prior to Surgery in Locally Advanced Cervical Cancer: A Single-Institute Prospective Study

• Published in: Cancer management and research 2020-01, Vol.12, p.12309-12317
• Main Authors: Qing, Defeng, Wu, Yuying, Liu, Xu, Jiang, Hailan, Zhu, Chaohua, Liu, Pei, Dang, Junming, Li, Xianglong, Chen, Zhaohong, Long, Xianfeng, Pang, Qiang, Peng, Luxing, Deng, Shan, Gu, Junzhao, Zhao, Renfeng, Chen, Changyi, Lu, Heming
• Format: Article
• Language: English
• Subjects: Abdomen; anti-egfr monoclonal antibody; Biopsy; Bone marrow; Cancer; Cancer therapies; Care and treatment; Cervical cancer; Chemotherapy; Development and progression; Growth factors; Gynecology; Health aspects; Hysterectomy; intensity-modulated radiotherapy; locally advanced cervical cancer; Lymphatic system; Magnetic resonance imaging; Medical imaging; Medical prognosis; Metastasis; Monoclonal antibodies; neoadjuvant chemotherapy; Oncology; Oncology, Experimental; Original Research; Patients; Radiation therapy; radical surgery; Radiotherapy; Recruitment; Statistical analysis; Surgery; Ultrasonic imaging; Women; Womens health
• ISSN: 1179-1322; 1179-1322
• DOI: 10.2147/CMAR.S282372

We aimed to evaluate the long-term survival outcomes of concurrent chemoradiotherapy (CCRT) combined with nimotuzumab followed by surgery in patients with locally advanced cervical cancer (LACC). Patients received whole pelvic intensity-modulated radiation therapy (IMRT) and concomitantly with weekly cisplatin (40 mg/m ) or nedaplatin (30 mg/m ) and weekly nimotuzumab (200 mg). After assessment of the treatment response, patients then underwent radical surgery. Between June 2013 and July 2016, 33 patients with FIGO IB2-IIIB cervical cancer were recruited. Clinical complete response and partial response were observed in 8 (24.3%) and 23 patients (69.7%), respectively. Twenty-seven patients (81.8%) were successfully treated with radical hysterectomy and pelvic lymphadenectomy: 9 (33.3%) showed pathological complete response; 10 (37.1%) showed partial response and 8 (29.6%) presented with persistent macroscopic/microscopic residual carcinoma. For the intention-to-treat population, the median follow-up time was 53.7 months. Locoregional recurrence and distant metastases were observed in three and seven patients, respectively. The 5-year overall survival, progression-free survival, locoregional recurrence-free survival, and distant metastasis-free survival were 81.5%, 72.7%, 90.9%, and 78.3%, respectively. Both acute and late toxicities were manageable and mainly limited to grade 1 or 2. Concurrent chemoradiotherapy combined with nimotuzumab followed by surgery for patients with LACC is safe and results in excellent long-term treatment outcomes. Further randomized controlled studies are warranted to confirm the findings.