Comparison of Carboplatin‐ and Cisplatin‐Based Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer Patients With Morbidity Risks

• Published in: The oncologist (Dayton, Ohio) Vol. 18; no. 7; pp. 843 - 849
• Main Authors: Nam, Eun Ji, Lee, Maria, Yim, Ga Won, Kim, Jae Hoon, Kim, Sunghoon, Kim, Sang Wun, Kim, Jae Wook, Kim, Young Tae
• Format: Journal Article
• Language: English
• Published: Durham, NC, USA AlphaMed Press 01.07.2013
• Subjects: Aged; Carboplatin; Carboplatin - administration & dosage; Carboplatin - adverse effects; Cervical cancer; Chemoradiotherapy; Cisplatin; Cisplatin - administration & dosage; Cisplatin - adverse effects; Combined Modality Therapy; Drug-Related Side Effects and Adverse Reactions - classification; Drug-Related Side Effects and Adverse Reactions - pathology; Female; Follow-Up Studies; Gynecologic Oncology; Humans; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - radiotherapy; Neoplasm Staging; Paclitaxel - administration & dosage; Survival Rate; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - radiotherapy; Carboplatin; Chemoradiotherapy; Cervical cancer; Cisplatin
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.2012-0455

Purpose. The aim of this study was to assess the activity and toxicity of primary carboplatin‐based chemoradiotherapy (CarboRT) and to compare CarboRT with cisplatin‐based chemoradiotherapy (CisRT) in patients with locally advanced cervical cancer and poor general condition. Patients and Methods. Fifty‐one locally advanced cervical cancer patients with morbidity risks were prospectively enrolled between January 2007 and April 2010. Eligible patients received weekly intravenous CarboRT with carboplatin 100 mg/m2, and a comparison was made with a historical patient group that received weekly CisRT with cisplatin 40 mg/m2. Results. Median follow‐up was 36 months (range: 4–66 months) in the CarboRT group and 53 months (range: 4–121 months) in the CisRT group. Compared with the historical CisRT group, the CarboRT group showed no statistically significant differences in recurrence (hazard ratio [HR], 1.21; 95% confidence interval [CI], 0.52–2.81) and survival (HR, 1.80; 95% CI, 0.49–6.54). The mean numbers of received cycles of CarboRT and CisRT were 7.5 ± 1.4 and 6.0 ± 1.8, respectively (p < .001). The rates of grade 3–4 toxicity were similar in the two groups. Conclusions. CarboRT was better tolerated than CisRT without compromising tumor response and survival in patients with locally advanced cervical cancer and poor general condition. 摘要 目的. 本研究旨在评估在一般情况较差的局部晚期宫颈癌患者中，以卡铂为基础的初步放化疗（CarboRT）方案的活性和毒性，并将其与以顺铂为基础的放化疗（CisRT）方案予以比较。 对象和方法. 本研究在2007年1月 ～2010年4月前瞻性地入组了51例存在病损风险的局部晚期宫颈癌患者。符合条件的患者接受每周1次静脉给药的CarboRT方案（卡铂100 mg/m2）；并与接受CisRT方案（顺铂40 mg/m2）的历史对照组相比较。 结果. CarboRT组的中位随访时间为36个月（范围：4 ～ 66个月），CisRT组为53个月（范围：4 ～ 121个月）。相比CisRT历史治疗组，CarboRT组在肿瘤复发[风险比（HR），1.21；95%可信区间（CI），0.52～ 2.81]和患者生存（HR，1.80；95%CI，0.49 ～6.54）方面未显示出明显差异。接受CarboRT方案和CisRT方案的平均疗程数分别为7.5± 1.4和6.0 ± 1.8（P ＜ 0.001）。两组的3 ～4级毒性反应发生率相似。 结论. 在一般情况较差的局部晚期宫颈癌患者中，相比CisRT方案，CarboRT方案耐受性较好，肿瘤应答率和患者生存无明显差异。 This study assessed the activity and toxicity of primary carboplatin‐based chemoradiotherapy (CarboRT) and compared CarboRT with cisplatin‐based chemoradiotherapy (CisRT) in patients with locally advanced cervical cancer and poor general condition. CarboRT was better tolerated than CisRT without compromising tumor response and survival in these patients.