Post on 22-Feb-2018
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Chemotherapy And
Radiotherapy for AdvancedCervical Cancer
Achmadi Sulistyo Nugroho
PICO
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1st Journal
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A Randomized Trial of Standard versus Partially
Hyperfractionated Radiation with or without Concurrent 5-Fluorouracil in ocally Advanced Cervical Cancer
GYNECOLOGIC ONCOLOGY 69, 137145
O Objcti! " dtrmin #hthr th addition o$concurrnt %&'uorouracil (%&)*+ and,or a changin radiation $ractionation im-ro!s -l!ic controland sur!i!al or dcrass com-lications in
ad!ancd cr!ical cancr. )IGO stags I/,IIA (0%cm+ to IA inclusi!2
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3atrial and 3thods
S
ubjct
4im " January 5667 8 9cmbr 5616
Patint slction intrnal databas
9ata collction rtros-cti!ly collctd
Sam-l si: " 51 -atints
Patint critria rci!d on -r!iouschmothra-y lin $or th tratmnt o$ incurabl
disas
"
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3atrial and 3thodsStratum 1 " thos #ith )IGO stag I/,IIA or stag II/ #ithStratum 5 includd thos #ith )IGO stag II/ disas #ith any lat
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Intr!ntion
A !arity o$ to-otcan
schduls #r -rscribd
62;% mg,m5 -r dayduring % conscuti! days
to 526 mg,m5 -r dayduring < conscuti! days
E!ry 51 days or #=lyto-otcan at gimn slction. dos
adjustmnts and dlays insubs?unt cycls byth assistant -hysician.according to clinical!aluation and -rsntdto@icitis2
istory. -hysical@amination andlaboratory !aluations#r obtaind -rior toach tratmnt cycl2
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Outcom
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Conclusion4o-otcan. as a singl agnt or in combination. @ihibits only modstacti!ity in a -o-ulation o$ -r!iously tratd -atints #ith cr!icalcancr albit at a cost o$ substantial hmatologic to@icity
4h limitd acti!ity o$ to-otcan schmas in scond& lintratmnt o$ cr!ical cancr and th associatd o!r& all to@icityas sho#n in this rtros-cti! study may not justi$y thir us inthis stting2
Patints #ho -rogrss a$tr Brst&lin tratmnt may b ord-artici-ation in clini& cal trials. othr scond&lin agnts or bstsu--orti! car masurs2
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2nd Jornal
Euro-an Journal o$ Cancr
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Objcti!Primary
th -ro-ortion o$ -atints #ith -rogrssion $r sur!i!al (P)S+$or at last F months and th $r?uncy and s!rity o$ad!rs !nts
Scondary
to stimat th -robability o$ clinical rs-ons. th
distribution o$ o!rall sur!i!al (OS+. th distribution o$P)S. and th im-act o$ -otntial -rognostic $actors on P)Sor OS2
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3atrial and 3thods
3
thods
4im " A-ril 5665 8 No!mbr 566F
4h study rci!d local institutional r!i# boarda--ro!al at -artici-ating institutions. and all -atintsga! in$ormd consnt according to institutional and
$dral guidlins b$or nrollmnt2
Sam-l si: " %6 -atints
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3atrial and 3thods*-&to&dat in$ormation on th dat o$
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!tcome comparison ! comparison "
11 -atints
-rogrssion$r $or at lastF months
% -atints
-artialrs-ons
3dian tim
rs-ons F251months
P)S
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Im-licationO There are two alternative neoad#uvant strate$ies to improve
lon$-term outcomes% &ne is a short cycle' dose intensive course
of cisplatin-(ased chemotherapy prior to radiotherapy% The
second is similar chemotherapy $iven prior to sur$ery )with or
without radiotherapy*'
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O sim-ulanO Pmbrian NAC sblum dila=u=ano-rasi mmbri=an man$aat yang lbihbsar dari-ada ji=a dila=u=an o-rasitan-a NAC dulu atau hanya dibri=anradiasi saja2
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"han# yo