(P001) Triapine Radiochemotherapy Improves Survival in Women With Stage IIIb Cervical Cancer

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Article
OncologyOncology Vol 28 No 1S
Volume 28
Issue 1S

Findings suggest that triapine radiochemotherapy provides improved cancer-related survival in women with stage IIIB cervical cancer.

Charles A. Kunos, MD, PhD, Tracy Sherertz, MD; Case Western Reserve University; Summa Health System; University Hospitals of Cleveland

Purpose: The Surveillance, Epidemiology and End Results (SEER) registry has published a 3-year cancer-related survival rate of 55% among the 2,236 cases of stage IIIB squamous cell cervical cancer between 1988 and 2001. Triapine irreversibly blocks ribonucleotide reductase, the de novo rate-limiting generator of DNA building blocks, and enhances cytotoxic effects of cisplatin chemotherapy and radiation therapy. Whether triapine radiochemotherapy reduces extrapelvic disease progression and disease-related death is not known.

Materials and Methods: Between 2006 and 2011, 12 women with clinical stage IIIB cervical cancer underwent three-times-weekly intravenous triapine (25 mg/m2), once-weekly cisplatin (40 mg/m2), and daily pelvic irradiation (45 Gy) followed by brachytherapy (30–40 Gy) on phase I and phase II trials. Lymph node positivity was determined by CT and positron emission tomography (PET) with [18F]-fluoro-2-deoxy-D-glucose (FDG). Cancer-related survival was evaluated by the Kaplan-Meier method.

Results: Median follow-up was 30 months (range: 4–90 mo). Pretherapy FDG-PET/CT detected abnormal FDG uptake in pelvic lymph nodes in 9 (75%) of the 12 stage IIIB women. One local (8 mo) and three distant (5, 23, and 24 mo) relapses have occurred after triapine radiochemotherapy. Two (17%) cervical cancer-related deaths and two (17%) non–cancer-related deaths have been observed. The 3-year cancer-related survival rate for women with stage IIIB cervical cancer was 74% (95% confidence interval [CI], 58%–90%), which compares favorably with a 55% SEER control.

Conclusions: Findings suggest that triapine radiochemotherapy provides improved cancer-related survival in women with stage IIIB cervical cancer. A prospective National Cancer Institute–sponsored (NCT01835171) randomized phase II trial of triapine radiochemotherapy vs radiochemotherapy has begun accrual nationwide.

Articles in this issue

(P113) Age and Marital Status Are Associated With Choice of Mastectomy in Patients Eligible for Breast Conservation Therapy
(P112) Single-Institution Experience With Intrabeam IORT for Treatment of Early-Stage Breast Cancer
(P110) Breast Cancer Before Age 40: Current Patterns in Clinical Presentation and Local Management
(P111) Accelerated Partial-Breast Irradiation With Multicatheter High-Dose-Rate Brachytherapy: Feasibility and Results in a Private Practice Cohort
(P115) Breast Cancer Laterality Does Not Influence Overall Survival in a Large Modern Cohort: Implications for Radiation-Related Cardiac Mortality
(P117) Anatomical Variations and Radiation Technique for Breast Cancer
(P116) Bilateral Immediate DIEP Reconstruction and Postmastectomy Radiotherapy: Experience at a Tertiary Care Institution
(P118) Metadherin Overexpression Is Associated With Improved Locoregional Control After Mastectomy
(P119) Effect of Economic Environment on Use of Postlumpectomy Radiation Therapy for Stage I Breast Cancer
(P120) Immediate Versus Delayed Reconstruction After Mastectomy in the United States Medicare Breast Cancer Patient
(P121) Trend in Age and Racial Disparities in the Receipt of Postlumpectomy Radiation Therapy for Stage I Breast Cancer: 2004–2009
(P122) Streamlining Referring Physicians Orders With ‘Reflex Testing’ Significantly Decreases Time to Resolution for Abnormal Screening Mammograms
(P123) National Trends in the Local Management of Early-Stage Paget Disease of the Breast
(P124) Effect of Inhomogeneity on Cardiac and Lung Dose in Partial-Breast Irradiation Using HDR Brachytherapy
(P125) Breast Cancer Outcomes With Anthracycline-Based Chemotherapy for Residual Disease Burden After Full-Dose Neoadjuvant Chemotherapy and Surgery Followed by Radiation Treatment
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