Abstract Locally-advanced cervical cancer is prevalent in Brazil's Northern region, with limited therapeutic options. Combining chemotherapy and radiotherapy is the standard, but the role of the addition of gemcitabine to cisplatin-based regimens remains under investigation. The present retrospective observational cohort study included patients with locally-advanced cervical cancer treated from 2009 to 2016 at the High-Complexity Oncology Unit in the city of Rio Branco, state of Acre. A total of 54 patients were allocated into 2 groups: group 1 received cisplatin alone, and group 2 received cisplatin combined with gemcitabine, both concurrent with external-beam radiotherapy and high-dose-rate brachytherapy. Progression-free survival and overall survival were analyzed using the Kaplan-Meier method, log-rank test, and Cox regression to evaluate the prognostic factors. At 36 months, the progression-free survival and overall survival rates were of 3.7% and 7.4% respectively in group 1, versus 37% for both outcomes in group 2. The hazard ratio for the progression-free survival was of 0.49 (p = 0.02), and for the overall survival, of 0.54 (p = 0.05). Group 2 presented a higher incidence of toxicities, including genitourinary events (p = 0.0005), peripheral neuropathy (p = 0.03), anemia grade ≥ 2 (p = 0.02), and neutropenia grade ≥ 3 (p = 0.03), although a detailed analysis was limited by the lack of standardization in the medical records. The addition of gemcitabine to cisplatin-based chemoradiotherapy improved progression-free survival in patients with locally-advanced cervical cancer. However, the benefit for overall survival was borderline, and increased toxicity was observed. Further prospective studies are warranted to confirm these findings.
Fernandes et al. (Sun,) studied this question.