Positron Emission Tomography-Guided Bone Marrow-Sparing Radiation Therapy for Locoregionally Advanced Cervix Cancer: Final Results From the INTERTECC Phase II/III Trial
Abstract
To test effects of positron emission tomography (PET)-based bone marrow-sparing (BMS) image-guided intensity modulated radiation therapy (IG-IMRT) on efficacy and toxicity for patients with locoregionally advanced cervical cancer. In an international phase II/III trial, patients with stage IB.IVA cervical carcinoma were treated with either PET-based BMS-IG-IMRT (PET-BMS-IMRT group) or standard image-guided IMRT (IMRT group), with concurrent cisplatin (40 mg/m2 weekly), followed by brachytherapy,The phase II component nonrandomly assigned patients to PET--BMS-IMRT or standard IMRT.The phase III trial randomized patients to PET-BMS-IMRT versus IMRT, with a primary endpoint of progression-free survival (PFS) but was closed early for futility.Conclusions: PET-BMS-IMRT significally reduced acute grade =>3 neutropenia, but not treatment-related lymphopenia, compared with standard IMRT.
We found no evidence that PET-BMS-IMRT affected chemotherapy delivery of long-term outcomes, and weak evidence of an association between pretreatment ALC and OS.