title: Carboplatin-based chemoradiotherapy in advanced cervical cancer: an alternative to cisplatin-based regimen?
abstract: OBJECTIVE
  To evaluate the results of treatment with cisplatin or carboplatin concomitant with radiotherapy (RT) in cases of locally advanced cervical cancer (CC).
  
  
  METHODS
  This study is a retrospective analysis of medical records of 184 patients with cervical cancer stage IIB-IVA who were treated at Instituto do Câncer do Estado de São Paulo from May 2008 to December 2012. All patients received complete pelvic region external-beam RT with weekly cisplatin (cis-RT, 40mg/m(2); n=159) or carboplatin (carbo-RT, AUC 2; n=25), followed by high-dose-rate intracavitary brachytherapy (HDR-ICBT). Primary endpoint was progression free survival; secondary endpoints were overall survival and overall response rate, which includes complete and partial responses.
  
  
  RESULTS
  Five or more chemotherapy cycles were administered to 87.3% and 84% of the cis-RT- and carbo-RT- treated patients, respectively (p=0.749). Estimated 3-years progression free survival was 59% in the cis-RT group vs 40% in the carbo-RT group (p=0.249). Estimated 3-years overall survival was 70% in the cis-RT group vs 68% in the carbo-RT group (p=0.298). Overall response rate (95.3% cis-RT vs 95.4% carbo-RT; p=0.911) and grade ≥3 toxic effects (8.5% cis-RT vs 11.8% carbo-RT; p=0.757) were similar. In multivariate analysis, only the overall response rate was a significant predictor of survival.
  
  
  CONCLUSIONS
  Patients with advanced cervical cancer who are treated with carbo-RT have similar 3-years overall survival, progression free survival, overall response rate, and toxic effects when compared to cis-RT-treated patients. Carbo-RT may be an alternative treatment in patients that cannot receive cisplatin.
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil. Electronic address: patyanne16@yahoo.com.br.
authors.forename: Ana Morais
authors.initials: AM
authors.lastname: Sebastião
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Lucila Soares
authors.initials: LS
authors.lastname: da Silva Rocha
authors.affiliation: Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Rodrigo Darouche
authors.initials: RD
authors.lastname: Gimenez
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Laryssa Almeida Borges
authors.initials: LA
authors.lastname: de Barros
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Julia Tizuko
authors.initials: JT
authors.lastname: Fukushima
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Samantha Cabral Severino
authors.initials: SC
authors.lastname: da Silva
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Vanessa
authors.initials: V
authors.lastname: da Costa Miranda
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Inacelli Queiros
authors.initials: IQ
authors.lastname: de Souza Caires
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Daniela
authors.initials: D
authors.lastname: de Freitas
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Elias Abdo
authors.initials: EA
authors.lastname: Filho
authors.affiliation: Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
authors.forename: Maria Del Pilar Estevez
authors.initials: Mdel P
authors.lastname: Diz
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D002945:Cisplatin
keywords: Carboplatin; Cervical cancer; Chemoradiotherapy; Cisplatin