We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

objective:To understand the relationship between digoxin toxicity and serum digoxin concentration.Methods:The criterion for diagnosis of digoxin toxicity was established.The serum digoxin concentration was measuredby fluorescence polarization immunoassay.Results:31 of 213 patients receiving digoxin were intoxicated.The incidence of toxicity was 14.5％.Conclusion:The occurence of digoxin toxicity is close related to serum digoxin levels,and the risk of digoxin toxicity is increased with the increase of serum digoxin concentration.

objective:To understand the relationship between digoxin toxicity and serum digoxin concentration.Methods:The criterion for diagnosis of digoxin toxicity was established.The serum digoxin concentration was measuredby fluorescence polarization immunoassay.Results:31 of 213 patients receiving digoxin were intoxicated.The incidence of toxicity was 14.5％.Conclusion:The occurence of digoxin toxicity is close related to serum digoxin levels,and the risk of digoxin toxicity is increased with the increase of serum digoxin concentration.