title: Radiation with cisplatin or carboplatin for locally advanced cervix cancer: the experience of a tertiary cancer centre.
abstract: BACKGROUND
  Definitive treatment with concurrent cisplatin and radiation is the standard of care for locally advanced cervix cancer. The optimal management of patients with a contraindication to cisplatin has not been established. We conducted a retrospective audit of concurrent chemotherapy in a cohort of patients with locally advanced cervix cancer.
  
  
  METHODS
  All patients with locally advanced cervix cancer treated with definitive radiation were entered into a prospective database. Information regarding their demographics, stage, histology, recurrence and survival were recorded. Pharmacy records were reviewed to determine concurrent chemotherapy use.
  
  
  RESULTS
  A total of 442 patients were included in the audit. Two hundred sixty-nine patients received cisplatin, 59 received carboplatin and 114 received no concurrent chemotherapy. Overall survival was significantly improved with the use of concurrent cisplatin compared with radiation alone (adjusted hazard ratio 0.53, P = 0.001), as was disease-free survival and rate of distant failure. The use of carboplatin was not associated with any significant benefit in terms of overall survival or disease-free survival.
  
  
  CONCLUSIONS
  The results of this audit are consistent with the known significant survival benefit with concurrent cisplatin chemotherapy. However, there did not appear to be any significant benefit with carboplatin although there were potential confounding factors. The available evidence in the literature would favour the use of non-platinum chemotherapy rather than carboplatin in patients with contraindications to cisplatin.
authors: Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. george.au-yeung@petermac.org
authors: George
authors: G
authors: Au-Yeung
authors: Linda
authors: L
authors: Mileshkin
authors: David M
authors: DM
authors: Bernshaw
authors: Srinivas
authors: S
authors: Kondalsamy-Chennakesavan
authors: Danny
authors: D
authors: Rischin
authors: Kailash
authors: K
authors: Narayan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000401:mortality*; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000628:therapy*; D014739:Victoria
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D002945:Cisplatin