Cancer Res Treat.  2012 Jun;44(2):97-103.

Phase II Study of Consolidation Chemotherapy after Adjuvant or Primary Concurrent Chemoradiation Using Paclitaxel and Carboplatin to Treat High-Risk Early-Stage or Locally Advanced Cervical Cancer

• Kim HS
• Kim MK
• Kim HJ
• Han SS
• Kim JW

Abstract

PURPOSE
This study investigated the efficacy and toxicity associated with consolidation chemotherapy using paclitaxel and carboplatin after concurrent chemoradiation (CCR) in cervical cancer patients.
MATERIALS AND METHODS
From a total of 37 patients, 19 with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer (group 1) underwent surgery followed by consolidation chemotherapy after CCR, and 18 with stage IIB-IVA disease (group 2) received consolidation chemotherapy after primary CCR. Three cycles of chemotherapy using paclitaxel (135 mg/m2) and carboplatin (AUC 5.0) were administered every 3 weeks for CCR therapy, and three cycles of consolidation chemotherapy using paclitaxel (175 mg/m2) and carboplatin (AUC 5.0) were used every 3 weeks after CCR.
RESULTS
The complete and partial response rates were 77.8% and 22.2% in group 2. Moreover, the 3-year progression-free and overall survival rates were 62.7% and 90.9% in group 1, and 51.9% and 60% in group 2, respectively. The most common grade 3 or 4 hematologic toxicities observed were leukopenia (group 1, 10.5%; group 2, 13.0%) and neutropenia (group 1, 7.0%; group 2, 14.8%), and grade 3 or 4 diarrhea (group 1, 1.8%) and febrile illness (group 2, 1.9%) were the most frequently observed non-hematologic toxicities. When we compared these results with previous reports, consolidation chemotherapy after CCR using paclitaxel and carboplatin revealed a relatively lower complete response rate (77.8% vs. 87-100%, respectively) and shorter progression-free survival (51.9-62.7% vs. 81-86%, respectively) and overall survival (60-90.9% vs. 81-95%, respectively) in spite of similar toxicity findings.
CONCLUSION
Due to low efficacy results, consolidation chemotherapy using paclitaxel and carboplatin after CCR is not a feasible treatment regimen for high-risk early-stage or locally advanced cervical cancer.

Keyword

Consolidation chemotherapy; Chemoradiotherapy; Paclitaxel; Carboplatin; Uterine cervical neoplasms

MeSH Terms

Carboplatin
Chemoradiotherapy
Consolidation Chemotherapy
Diarrhea
Disease-Free Survival
Gynecology
Humans
Leukopenia
Neutropenia
Obstetrics
Paclitaxel
Survival Rate
Uterine Cervical Neoplasms
Carboplatin
Paclitaxel

Figure

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  Fig. 1 Efficacy of paclitaxel and carboplatin as consolidation chemotherapy after concurrent chemoradiation (CCR) in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA (group 1) and stage IIB-IVA (group 2) cervical cancer; (A) progression-free survival and (B) overall survival curves for 19 patients who underwent primary surgery followed by three cycles of consolidation chemotheray after CCR (group 1) and 18 patients who received primary CCR followed by three cycles of consolidation chemotherapy (group 2).

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