Long-term outcomes of concurrent chemoradiotherapy with weekly carboplatin in locally-advanced carcinoma of the uterine cervix patients.
OBJECTIVE
To study the treatment outcomes of concurrent chemoradiotherapy with weekly carboplatin in locally-advanced carcinoma of the uterine cervix patients and the complications resulting from the treatment.


METHODS
Between August 2005 and July 2007, the author identified 105 patients with carcinoma of the uterine cervix. The International Federation of Gynecology and Obstetrics Clinical Stages were IIB, III, and IVA in 83, 19, and three cases, respectively. Mean age was 51.5 years old, ranging from 33 to 79 years. Carboplatin was prescribed weekly concurrent with external irradiation.


RESULTS
The most acute toxicities were in grade 1-2 (grade 3 hematological toxicities were 3.80%). Complete response was achieved in 95 patients (90.5%). Among the 95 responders, 27 experienced recurrences: local recurrences in eight (8.4%), distant failure in 17 (17.9%), and both local and distant failure in two (2.1%). The follow-up time was ranging from three to 96 months (median 76 months). Significant prognostic factors for disease-free survival in multivariate Cox regression analysis were tumor stage and tumor response. With regard to overall survival, multivariate Cox regression analysis confirmed prognostic significance of patients' age, tumor stage, and tumor response. Five-year disease free survival rate was 52.38% (56.63%, 42.11%, and 0% in stage IIB, III, and IVA, respectively) while five-year overall survival rate was 56.19% (61.45%, 42.11%, and 0% in stage IIB, III, and IVA, respectively). Late grade 3-4 gastrointestinal and genitourinary toxicities were 3.2% and 0%, respectively.


CONCLUSIONS
Concurrent weekly carboplatin and radiation therapy yields high response rate with modest disease-free and overall survivals in locally advanced carcinoma of the uterine cervix. The regimen is feasible with minimal toxicities. Prognostic factors identified in the present study are consistent with other reports.
Somphob
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Sangkittipaiboon
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
D000970:Antineoplastic Agents; D016190:Carboplatin