title: Platinum-free interval in second-line chemotherapy for recurrent cervical cancer.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the platinum-free interval (PFI) was a predictive indicator in second-line treatment of cervical cancer in patients who had undergone prior platinum-based chemotherapy. The role of the PFI in selecting the second-line regimen in other gynecologic malignancies is also discussed.
  
  
  METHODS
  In this retrospective study, we examined the clinical records of patients with recurrent or metastatic cervical cancer who had received platinum-containing combination regimens as second-line chemotherapy. All patients had received prior platinum-containing chemotherapy or concurrent chemoradiotherapy.
  
  
  RESULTS
  The overall response rate to second-line chemotherapy was 25.8%; 7 patients achieved a complete response and 17 a partial response. The median progression-free survival (PFS) was 5.1 months and median overall survival (OS) was 13.5 months. The response rate was 12.5%, 14.2%, 20.0%, 22.2%, and 55.0%; median PFS was 4.0, 5.1, 4.4, 5.8, and 7.4 months; and median OS was 10.2, 14.4, 11.9, 16.3, and 19.7 months when PFI was within 3, 3 to 5, 6 to 11, 12 to 23, and more than 24 months, respectively. Age (>50 years), size (>3 cm), prior radiotherapy, and PFI (>24 months) were identified as prognostic factors in the multivariate analysis for PFS and OS.
  
  
  CONCLUSIONS
  The results indicate that a PFI of more than 24 months is the discriminating point between platinum-sensitive and platinum-resistance cervical cancer. This indicates that PFI offers a useful tool in selecting agents for second-line chemotherapy in a wide range of gynecologic malignancies.
authors.affiliation: Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Matoda
authors.forename: Terumi
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Kohei
authors.initials: K
authors.lastname: Omatsu
authors.forename: Norichika
authors.initials: N
authors.lastname: Ushioda
authors.forename: Akiko
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Sanshiro
authors.initials: S
authors.lastname: Okamoto
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kawamata
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kato
authors.forename: Kenji
authors.initials: K
authors.lastname: Umayahara
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshima
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy* / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D002945:Cisplatin