J Gynecol Oncol.  2009 Mar;20(1):28-34. 10.3802/jgo.2009.20.1.28.

Comparison of concurrent chemoradiotherapy with cisplatin plus 5-fluorouracil versus cisplatin plus paclitaxel in patients with locally advanced cervical carcinoma

• Sol ES
• Lee TS
• Koh SB
• Oh HK
• Ye GW
• Choi YS

• KMID: 2055645
• DOI: http://doi.org/10.3802/jgo.2009.20.1.28

Abstract

OBJECTIVE
The aim of this study was to compare survival outcomes and toxicities between concurrent radiotherapy with cisplatin plus 5-fluorouracil and that with cisplatin plus paclitaxel in patients with locally advanced cervical carcinoma.
METHODS
We retrospectively reviewed data from 93 locally advanced cervical carcinoma patients (stage IB to IVA) who had been treated by concurrent radiotherapy with cisplatin plus 5-fluorouracil (CF, n=45) vs. cisplatin plus paclitaxel (CP, n=48) as primary therapy. Toxicities and survival outcomes were compared.
RESULTS
In the CP group, there were higher frequencies of severe (grade 3 or 4) leukopenia (79.2%, as compared to 11.1% in the CF group), severe neutropenia (77.1%, as compared to 8.9% in the CF group) and severe peripheral neuropathy (12.5%, as compared to 2.2% in the CF group). In the CF group, there were higher frequencies of severe nausea (33.3%, as compared to 14.6% in the CP group) and severe hyponatremia (11.1%, as compared to 0% in the CP group). Five-year DFS of the CF and CP groups was 67.4% and 79.1%, respectively (p=NS). Five year OS of the CF and CP groups was 79.6% and 80.9%, respectively (p=NS).
CONCLUSION
Concurrent radiotherapy with cisplatin plus paclitaxel showed increased leukopenia, neutropenia and peripheral neuropathy, but less gastrointestinal toxicity (nausea) than that with cisplatin plus 5-fluorouracil. Survival outcome between these two groups was not statistically different in this study. Large prospective randomized controlled studies will be needed to confirm this result.

Keyword

Cervical cancer; Chemoradiotherapy; Cisplatin; 5-fluorouracil; Paclitaxel

MeSH Terms

Chemoradiotherapy
Cisplatin
Fluorouracil
Humans
Hyponatremia
Leukopenia
Nausea
Neutropenia
Paclitaxel
Peripheral Nervous System Diseases
Retrospective Studies
Uterine Cervical Neoplasms
Cisplatin
Fluorouracil
Paclitaxel

Figure

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  Fig. 1 (A) Kaplan-Meier estimates of disease free survival among patients undergoing chemoradiotherapy with cisplatin plus 5-fluorouracil (n=45) or plus paclitaxel (n=48). (B) Kaplan-Meier estimates of overall survival among patients undergoing chemoradiotherapy with cisplatin plus 5-fluorouracil (n=45) or plus paclitaxel (n=48).

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