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CC BY 4.0 · Brazilian Journal of Oncology 2026; 22: s00451810446
DOI: 10.1055/s-0045-1810446
Original Article
Clinical Oncology

Impact of the Addition of Gemcitabine to Cisplatin-based Chemoradiotherapy on Survival in Locally-Advanced Cervical Cancer: A Retrospective Study in Acre

Authors

  • Vitoria Fernandes 

    1   School of Medicine, Federal University of Acre, Rio Branco, AC, Brazil
    3   Department of Public Health, Center for Health and Sports Sciences, Federal University of Acre, Rio Branco, AC, Brazil

  • Lyvia Bessa 

    2   High-Complexity Oncology Unit (UNACON), Acre State Hospital Foundation (Fundhacre) Rio Branco, AC, Brazil

  • Rafael Teixeira 

    2   High-Complexity Oncology Unit (UNACON), Acre State Hospital Foundation (Fundhacre) Rio Branco, AC, Brazil

  • Liz Souza 

    3   Department of Public Health, Center for Health and Sports Sciences, Federal University of Acre, Rio Branco, AC, Brazil

  • Luiz Henrique Freire 

    1   School of Medicine, Federal University of Acre, Rio Branco, AC, Brazil
    3   Department of Public Health, Center for Health and Sports Sciences, Federal University of Acre, Rio Branco, AC, Brazil
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Abstract

Introduction

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.

Materials and Methods

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.

Results

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.

Conclusion

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.

Keywords

clinical oncology - chemotherapy protocol - antineoplastic - uterine cervical neoplasms

Authors' Contributions

VF: conceptualization; methodology; data curation; investigation; formal analysis; writing – original draft; writing – review and editing; visualization; project administration. LB: conceptualization; methodology; supervision; validation; writing – review. RT: conceptualization; methodology; supervision; validation; writing – review. LS: formal analysis; methodology; data curation; writing – review & editing. LHF: investigation; data curation.




Publication History

Received: 20 January 2025

Accepted: 19 May 2025

Article published online:
25 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Vitoria Fernandes, Lyvia Bessa, Rafael Teixeira, Liz Souza, Luiz Henrique Freire. Impact of the Addition of Gemcitabine to Cisplatin-based Chemoradiotherapy on Survival in Locally-Advanced Cervical Cancer: A Retrospective Study in Acre. Brazilian Journal of Oncology 2026; 22: s00451810446.
DOI: 10.1055/s-0045-1810446
 

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