Concurrent chemoradiotherapy combined with immunotherapy is superior to traditional concurrent chemoradiotherapy in the treatment of advanced cervical cancer

Purpose of investigation: In advanced cervical cancer, traditional therapy included concurrent chemoradiotherapy (CCRT), pelvic radiotherapy, and brachytherapy. In the last few years, the development of using of immunotherapy (IMT), targeted therapy, angiogenesis inhibitors, and tyrosine kinase inhibitors encourage us to provide better treatment choices in advanced cervical cancer patients. In this study, the authors propose CCRT combined with immunotherapy (ICRT) as a better treatment option for advanced cervical cancer. Materials and Methods: The authors retrospectively reviewed the medical records of 23 patients with advanced cervical who were treated by CCRT or ICRT between 2000 and 2016 at Chang Gung Memorial Hospital. In CCRT group (total 15 cases), patients were treated with traditional platinum-based chemotherapy and radiotherapy. In ICRT group (total eight cases), patients were treated with CCRT and adjuvant IMT. The authors chose Picibanil (OK-432) plus interleukin-2 (IL-2) for adjuvant IMT. Between CCRT and ICRT groups, they analyzed the difference of age, histological type of cervical cancer, follow-up period, recurrence rate, and diagnosis-to-recurrence period between them. They also analyzed the difference of complete blood cell counts and its differentiating counts after one month of treatment. Results: Within these parameters, the recurrence rate between ICRT and CCRT group showed significant difference (37.5% vs. 86.67%, p = 0.0257). The authors observed that diagnosis-to-recurrence duration was longer in ICRT group than CCRT group (67.32 months vs. 11.92 months, p = 0.1464), although there was no statistical significance found. The laboratory findings one month after treatment showed significant difference in absolute lymphocyte counts (ALC), which showed 1,554.23/mu L vs. 577.38/mu L (mean value, p = 0.0011) in ICRT and CCRT group respectively. Conclusions: This study indicated that CCRT combined with immunotherapy is superior to traditional CCRT in treatment of advanced cervical cancer.