What question did this study set out to answer?

This research aims to determine if adjuvant concurrent chemotherapy with pelvic IMRT improves outcomes for early-stage cervical cancer patients with intermediate risk factors.

April 4, 2026Open Access

Adjuvant concurrent chemoradiotherapy for early-stage cervical cancer patients with intermediate-risk factors in the era of intensity-modulated radiation therapy

SWSitong WangNorth University of China GMGui-Fen MaSun Yat-sen University CXChunli XiaoSun Yat-sen University

Key Points

This research aims to determine if adjuvant concurrent chemotherapy with pelvic IMRT improves outcomes for early-stage cervical cancer patients with intermediate risk factors.
Analyzed 244 women with stage IB-IIA cervical cancer who underwent radical hysterectomy and pelvic lymph node dissection from 2012 to 2023.
Divided cohorts: 139 received IMRT plus concurrent chemoradiotherapy; 105 received IMRT alone.
Used clinical parameters, overall survival, and recurrence-free survival for analysis.
Median follow-up was 61.2 months, ranging from 6.3 to 144.4 months.
Five-year overall survival rates were 96.7% for IMRT and 94.4% for chemoradiotherapy (p=0.271).
Five-year recurrence-free survival rates were 88.1% for IMRT and 86.9% for chemoradiotherapy (p=0.740).
Only adenocarcinoma histology significantly affected overall and recurrence-free survival.

Abstract

Objectives: To investigate whether adjuvant concurrent chemotherapy with pelvic intensitymodulated radiotherapy (IMRT) improves the outcome of patients with early-stage cervical cancer with intermediate risk factors (IRFs) compared with IMRT alone.Methods: This study included a cohort of 244 women from January 2012 to October 2023 who underwent radical hysterectomy along with pelvic lymph node dissection (PLND) for stage IB-IIA cervical cancer with IRFs.One hundred thirty-nine patients were postoperatively treated with pelvic IMRT (45.0-50.4Gy) and adjuvant concurrent chemoradiotherapy (CCRT) (weekly cisplatin or weekly or triweekly combination of paclitaxel and cisplatin).One hundred five patients were treated with pelvic IMRT alone.The significance of clinical parameters, overall survival (OS), and recurrence-free survival (RFS) of each arm were analyzed.Results: The median follow-up period was 61.2 months, with a range spanning from 6.3 to 144.4 months.The 5-year OS rates in the patients in the radiotherapy (RT) and CCRT arms were 96.7% and 94.4%, respectively (p=0.271).Five-year RFS was 88.1% in the RT arm and 86.9% in the CCRT arm (p=0.740).Multivariate analysis identified adenocarcinoma (AC) histology as the only significant prognostic factor affecting OS and RFS. Conclusion:This study demonstrates that even in the era of IMRT, CCRT is not more effective than RT alone in patients with stage IB-IIA cervical cancer with IRFs following radical hysterectomy with PLND.

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Cite This Study

Wang et al. (Thu,) studied this question.

synapsesocial.com/papers/69d0adc2659487ece0fa4404 https://doi.org/https://doi.org/10.3802/jgo.2026.37.e93

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