Long-Term Results of a Phase II Trial of Concomitant Cisplatin-Paclitaxel Chemoradiation in Locally Advanced Cervical Cancer. Issue 6 (1st July 2016)

• Record Type: Journal Article
• Authors: Martínez-Fernández, María Isabel; Legaspi Folgueira, Jairo; Valtueña Peydró, Germán; Cambeiro, Mauricio; Espinós, Jaime; Aramendía, José Manuel; Minguez-Milio, José A.; Martínez-Monge, Rafael
• Is Part Of: International journal of gynecological cancer. Volume 26:Issue 6(2016)
• Page Start: 1162
• Page End: 1168
• Publication Date: 2016-07-01
• Subjects: Cisplatin -- Paclitaxel -- Chemoradiation -- Locally advanced cervical cancer; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000000744
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: The aim of this study was to determine the long-term results of a 7-week schedule of external beam radiation therapy, high dose rate brachytherapy, and weekly cisplatin and paclitaxel in patients with locally advanced carcinoma of the cervix. Methods: Thirty-seven patients with International Federation of Gynecology and Obstetrics stages IB2 to IVa cervical cancer were treated with 40 mg/m 2 per week of intravenous cisplatin and 50 mg/m 2 per week of intravenous paclitaxel combined with 45 Gy of pelvic external beam radiation therapy and 28 to 30 Gy of high dose rate brachytherapy. Results: Sixteen patients (43.2%) were able to complete the 6 scheduled cycles of chemotherapy. The median number of weekly chemotherapy cycles administered was 5. Thirty-six (16.2%) of 222 cycles of chemotherapy were not given because of toxicity. The mean dose intensity of cisplatin was 29.6 mg/m 2 per week (95% confidence interval, 27.0–32.1); that of paclitaxel was 40.0 mg/m 2 per week (95% confidence interval, 36.9–43.1). Thirty-four patients (91.8%) completed the planned radiation course in less than 7 weeks. Median radiation treatment length was 43 days. After a median follow-up of 6 years, 7 patients (18.9%) experienced severe (RTOG grade 3 or higher) late toxicity. No fatal events were observed. Ten patients have failed, 1 locally and 9 at distant sites. The 14-year locoregional control rate was 96.7%, and the 14-year freedom from systemic failure rate was 64.6%. Fourteen-year actuarial disease-free survival and overall survival rates were 44.8% and 50%, respectively. Conclusions: This study demonstrates excellent very long-term results and tolerable toxicity although the target weekly dosage of cisplatin and paclitaxel needs to be adjusted in the majority of the patients.