title: Chemoradiotherapy followed by consolidation chemotherapy involving paclitaxel and carboplatin and in FIGO stage IIIB/IVA cervical cancer patients.
abstract: OBJECTIVE
  To evaluate the efficacy and toxicity of paclitaxel plus carboplatin (TC)-based concurrent chemoradiotherapy (CCRT) followed by consolidation chemotherapy in the International Federation of Gynecology and Obstetrics (FIGO) stage IIIB/IVA cervical cancer patients.
  
  
  METHODS
  We reviewed the medical records of FIGO stage IIIB/IVA cervical cancer patients (n=30) who had been intended to be treated with TC-based CCRT followed by consolidation chemotherapy (TC-CCRT-group) from April 2012-May 2016. Patients who had been treated with CCRT involving a single platinum agent (CCRT-group; n=52) or definitive radiotherapy alone (RT-group; n=74) from January 1997-September 2012 were also identified and used as historical controls. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test.
  
  
  RESULTS
  Of the 30 patients included in the TC-CCRT-group, 22 patients (73.3%) completed the planned TC-based CCRT. The most frequently observed acute grade 3/4 hematological toxicities were leukopenia and neutropenia, and diarrhea was the most common acute grade 3/4 non-hematological toxicity. After a median follow-up of 35 months, 9 patients (30.0%) had developed recurrent disease. The patients' estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 67.9% and 90.8%, respectively. In comparisons with historical control groups, the survival outcomes of TC-CCRT-group was significantly superior to CCRT-group in terms of OS (p=0.011) and significantly superior to RT-group in terms of both PFS (p=0.009) and OS (p<0.001).
  
  
  CONCLUSIONS
  TC-based CCRT followed by consolidation chemotherapy is safe and effective. A randomized controlled study needs to be conducted to further evaluate the efficacy of this multimodal approach in this patient population.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan. smabuchi@gyne.med.osaka-u.ac.jp.
authors.forename: Seiji
authors.identifier: http://orcid.org/0000-0003-1803-1166
authors.initials: S
authors.lastname: Mabuchi
authors.affiliation: Department of Radiation Oncology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Fumiaki
authors.identifier: http://orcid.org/0000-0001-6342-4693
authors.initials: F
authors.lastname: Isohashi
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Mika
authors.identifier: http://orcid.org/0000-0002-6439-856X
authors.initials: M
authors.lastname: Okazawa
authors.affiliation: Department of Obstetrics and Gynecology, Suita Tokusyukai Hospital, Osaka, Japan.
authors.forename: Fuminori
authors.identifier: http://orcid.org/0000-0001-7387-0814
authors.initials: F
authors.lastname: Kitada
authors.affiliation: Department of Radiology, Suita Tokusyukai Hospital, Osaka, Japan.
authors.forename: Shintaro
authors.identifier: http://orcid.org/0000-0002-0239-7107
authors.initials: S
authors.lastname: Maruoka
authors.affiliation: Department of Radiation Oncology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazuhiko
authors.identifier: http://orcid.org/0000-0001-8872-7690
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University, Graduate School of Medicine, Osaka, Japan.
authors.forename: Tadashi
authors.identifier: http://orcid.org/0000-0002-4391-6866
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016022:Case-Control Studies; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000009:adverse effects; D003131:Combined Modality Therapy; D060830:Consolidation Chemotherapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin
keywords: Chemoradiotherapy; Consolidation Chemotherapy; Prognosis; Uterine Cervical Neoplasms