The activity of carboplatin and paclitaxel for recurrent cervical cancer after definitive radiotherapy.
OBJECTIVE
The aim of this study was to evaluate the efficacy of paclitaxel-carboplatin (TC) for recurrent cervical cancer after definitive radiotherapy and to compare the results with non-taxane containing platinum-based chemotherapies (NTP).


METHODS
The records of 59 consecutive women who had undergone salvage chemotherapy with TC (n=28) or NTP (historical control, n=31) for recurrence after definitive radiotherapy were retrospectively reviewed. Primary disease and recurrence data was collected. The activity and toxicity of TC were compared with those of NTP. The response rate and progression-free survival (PFS) after recurrence were the main endpoints. Multivariate analysis of prognostic factors for response was performed using the Cox proportional hazards regression model. Survival was calculated using the Kaplan-Meier methods and compared by the log-rank test.


RESULTS
Overall, TC was well tolerated with a response rate of 67.9% (5 CR and 14 PR). The median PFS was 7 months for all patients and 10 months for responders. Myelosuppression was the most common toxicity (grade 3 in 16 patients, grade 4 in 5 patients). On the contrary, NTP showed a response rate of 22.6% with median and mean PFS of 0 month and 2 months, respectively. When compared, TC was significantly superior to NTP with regard to its response rate (p=0.001) and PFS (p<0.0001). Moreover, TC showed significantly higher activity in patients with adenocarcinoma histology.


CONCLUSIONS
Carboplatin-paclitaxel is active and well tolerated in patients with recurrent cervical cancer after definitive radiotherapy. This combination should be considered as an alternative regimen to cisplatin-paclitaxel in this patient population.
Mabuchi
Seiji
S
Department of Obstetrics and Gynecology, Osaka University Graduate school of Medicine, Suita, Osaka, Japan. smabuchi@gyne.med.osaka-u.ac.jp
Morishige
Kenichirou
K
Fujita
Masami
M
Tsutsui
Tateki
T
Sakata
Masahiro
M
Enomoto
Takayuki
T
Kimura
Tadashi
T
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D016879:Salvage Therapy; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy
D016190:Carboplatin; D017239:Paclitaxel