Chemoradiotherapy followed by consolidation chemotherapy involving paclitaxel and carboplatin and in FIGO stage IIIB/IVA cervical cancer patients.
- Author:
Seiji MABUCHI
1
;
Fumiaki ISOHASHI
;
Mika OKAZAWA
;
Fuminori KITADA
;
Shintaro MARUOKA
;
Kazuhiko OGAWA
;
Tadashi KIMURA
Author Information
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords: Uterine Cervical Neoplasms; Chemoradiotherapy; Consolidation Chemotherapy; Prognosis
- MeSH: Carboplatin*; Chemoradiotherapy*; Consolidation Chemotherapy*; Diarrhea; Disease-Free Survival; Follow-Up Studies; Gynecology; Humans; Leukopenia; Medical Records; Methods; Neutropenia; Obstetrics; Paclitaxel*; Platinum; Prognosis; Radiotherapy; Uterine Cervical Neoplasms*
- From:Journal of Gynecologic Oncology 2017;28(1):e15-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To evaluate the efficacy and toxicity of paclitaxel plus carboplatin (TC)-based concurrent chemoradiotherapy (CCRT) followed by consolidation chemotherapy in the International Federation of Gynecology and Obstetrics (FIGO) stage IIIB/IVA cervical cancer patients. METHODS: We reviewed the medical records of FIGO stage IIIB/IVA cervical cancer patients (n=30) who had been intended to be treated with TC-based CCRT followed by consolidation chemotherapy (TC-CCRT-group) from April 2012–May 2016. Patients who had been treated with CCRT involving a single platinum agent (CCRT-group; n=52) or definitive radiotherapy alone (RT-group; n=74) from January 1997–September 2012 were also identified and used as historical controls. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test. RESULTS: Of the 30 patients included in the TC-CCRT-group, 22 patients (73.3%) completed the planned TC-based CCRT. The most frequently observed acute grade 3/4 hematological toxicities were leukopenia and neutropenia, and diarrhea was the most common acute grade 3/4 non-hematological toxicity. After a median follow-up of 35 months, 9 patients (30.0%) had developed recurrent disease. The patients' estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 67.9% and 90.8%, respectively. In comparisons with historical control groups, the survival outcomes of TC-CCRT-group was significantly superior to CCRT-group in terms of OS (p=0.011) and significantly superior to RT-group in terms of both PFS (p=0.009) and OS (p<0.001). CONCLUSION: TC-based CCRT followed by consolidation chemotherapy is safe and effective. A randomized controlled study needs to be conducted to further evaluate the efficacy of this multimodal approach in this patient population.
