J Gynecol Oncol.  2017 Jan;28(1):e15. 10.3802/jgo.2017.28.e15.

Chemoradiotherapy followed by consolidation chemotherapy involving paclitaxel and carboplatin and in FIGO stage IIIB/IVA cervical cancer patients

• Mabuchi S
• Isohashi F
• Okazawa M
• Kitada F
• Maruoka S
• Ogawa K
• Kimura T

• KMID: 2413856
• DOI: http://doi.org/10.3802/jgo.2017.28.e15

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.

Keyword

Uterine Cervical Neoplasms; Chemoradiotherapy; Consolidation Chemotherapy; Prognosis

MeSH Terms

Adult
Aged
Antineoplastic Agents/administration & dosage/adverse effects
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
Carboplatin/administration & dosage/adverse effects
Carcinoma, Squamous Cell/mortality/pathology/*therapy
Case-Control Studies
Chemoradiotherapy/*methods
Cisplatin/adverse effects
Combined Modality Therapy
Consolidation Chemotherapy/*methods
Disease-Free Survival
Female
Humans
Middle Aged
Neoplasm Staging
Paclitaxel/administration & dosage/adverse effects
Retrospective Studies
Survival Rate
Uterine Cervical Neoplasms/mortality/pathology/*therapy
Young Adult
Antineoplastic Agents
Carboplatin
Paclitaxel
Cisplatin