Management of Advanced, Metastatic, and Recurrent Cervical Cancer: Survey of Practice among Thai Gynecologic Oncologists
Achariyapota V, MD1, Pohthipornthawat N, MD2, Inthasorn P, MD1, Termrungruanglert W, MD2, Srisomboon J, MD3, Chanpanitkitchot S, MD4, Charakorn C, MD5, Charoenkwan K, MD, MSc3, Thai Gynecologic Cancer Society (TGCS)6
Affiliation : 1 Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand 3 Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand 4 Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand 5 Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 6 Office of Thai Gynecologic Cancer Society, Royal Golden Jubilee Building, Bangkok, Thailand
Objective : To evaluate the current practice of Thai gynecologic oncologists in the management of patients with advanced, metastatic,
and recurrent cervical cancer.
Materials and Methods : This study was a part of the national practice survey on the management of gynecologic cancer in Thailand.
All Thai gynecologic oncologists were targeted in the survey. This study retrieved the data regarding the practice of management
of advanced-stage cervical cancer and recurrent disease.
Results : Of 170 respondents, 90% used combination platinum/paclitaxel chemotherapy as a first-line treatment for patients with
advanced and recurrent diseases. The combination of chemotherapy was used in about 81.8% and 27.6% in first-line and further
line treatments, respectively. Single cisplatin was used in 14.1% as the second-line. Palliative treatment without chemotherapy was
considered increasingly after first-line treatment and significantly more likely to implement among service hospitals compared to
the comparative setting (8.9% vs. 1.2%: p = 0.030). Up to 36.6% (30/82) of the respondents who worked in training hospitals
preferred to use targeted therapy, i.e. bevacizumab compared to 21.3% (16/75) of respondents who worked in service hospitals
(p = 0.04).
Conclusion : Combination platinum-based chemotherapy was commonly used as the first-line treatment for advanced and recurrent
cervical cancer. The respondents in training hospitals were more likely to use targeted therapy than those in the service hospitals.
Keywords : Cervical cancer, Advanced cervical cancer, Recurrent cervical cancer, Chemotherapy, Targeted therapy, Practice, Survey
