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KMID : 1137020090200030146
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Journal of Gynecologic Oncology
2009 Volume.20 No. 3 p.146 ~ p.150
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Prognostic significance of neutropenia during adjuvant concurrent chemoradiotherapy in early cervical cancer
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Kim Yun-Hwan
Kim Jae-Weon
Park Noh-Hyun
Chung Hyun-Hoon
Song Yong-Sang
Kang Soon-Beom
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Abstract
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Objective: To evaluate the prognostic significance of adjuvant concurrent chemoradiotherapy-induced neutropenia with survival in patients with squamous cell carcinoma of the uterine cervix.
Methods: Data from 107 patients with stage IB-IIB cervical cancer were retrospectively analyzed. The median follow-up was 37.5 (4.2-72.7) months. All patients had received radical surgery, including pelvic lymphadenectomy, followed by paclitaxel plus carboplatin-based concurrent chemoradiotherapy. Relative neutropenia, defined as an absolute neutrophil count <1,000/mm3 at the concurrent chemoradiotherapy cycle nadir, correlated to the pathologic findings and survival outcomes.
Results: Sixty-six patients experienced neutropenia at least once during concurrent chemoradiotherapy, and demonstrated marginal improvement in disease-free survival (p=0.055), although not in overall survival. By subgroup analyses, the gain of disease free survival mainly originated from the node metastasis subgroup (p=0.033). Treatment-induced neutropenia proved to be the only significant independent factor for recurrence in cervical cancer (p=0.042) by multivariate analysis.
Conclusion: Concurrent chemoradiotherapy-induced neutropenia may be a prognostic factor of recurrence in patients with cervical cancer. Individualized dose titration of the tolerable myelosuppression might be beneficial.
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KEYWORD
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Uterine cervical cancer, Chemoradiotherapy, Neutropenia, Survival
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