A phase II randomized trial comparing radiotherapy with concurrent weekly cisplatin or weekly paclitaxel in patients with advanced cervical cancer

Fady B Geara,Maya Charafeddine,Muhieddine Seoud,Ali Khalil,Ali Shamseddine,Mirna Abboud

doi:10.1186/1748-717x-5-84

Fady B Geara, Maya Charafeddine + Show 4 more

Open Access

https://doi.org/10.1186/1748-717x-5-84

Copy DOI

Abstract

Purpose/ObjectiveThis is a prospective comparison of weekly cisplatin to weekly paclitaxel as concurrent chemotherapy with standard radiotherapy for locally advanced cervical carcinoma.Materials/MethodsBetween May 2000 and May 2004, 31 women with FIGO stage IB2-IVA cervical cancer or with postsurgical pelvic recurrence were enrolled into this phase II study and randomized to receive on a weekly basis either 40 mg/m2 Cisplatin (group I; 16 patients) or 50 mg/m2 paclitaxel (group II; 15 patients) concurrently with radiotherapy. Median total dose to point A was 74 Gy (range: 66-92 Gy) for group I and 66 Gy (range: 40-98 Gy) for group II. Median follow-up time was 46 months.ResultsPatient and tumor characteristics were similar in both groups. The mean number of chemotherapy cycles was also comparable with 87% and 80% of patients receiving at least 4 doses in groups I and II, respectively. Seven patients (44%) of group I and 8 patients (53%) of group II developed tumor recurrence. The Median Survival time was not reached for Group I and 53 months for group II. The proportion of patients surviving at 2 and 5 years was 78% and 54% for group I and 73% and 43% for group II respectively.ConclusionsThis small prospective study shows that weekly paclitaxel does not provide any clinical advantage over weekly cisplatin for concurrent chemoradiation for advanced carcinoma of the cervix.

Highlights

In many developing countries, cervical cancer remains a major public health problem with high overall incidence and higher frequency of advanced stage at diagnosis
The proportion of patients surviving at 2 and 5 years was 78% and 54% for group I and 73% and 43% for group II respectively. This small prospective study shows that weekly paclitaxel does not provide any clinical advantage over weekly cisplatin for concurrent chemoradiation for advanced carcinoma of the cervix
We examine the tumor response, treatment toxicity, and outcome of patients with locally advanced cervical cancer treated by concurrent radiation therapy and chemotherapy using either weekly Cisplatin or weekly paclitaxel

Summary

Introduction

Cervical cancer remains a major public health problem with high overall incidence and higher frequency of advanced stage at diagnosis. Radiation therapy remains the main treatment modality for patients with advanced cervical cancer the results of which depend on disease stage, tumor volume, presence of involved lymph nodes, delivered radiation dose, treatment duration, hemoglobin level, and the optimal use of intracavitary brachytherapy [1,2,3,4,5]. Despite the use of concurrent CTRT, many patients continue to fail in the pelvis (20-25%) and at distant sites (10-20%), [6,16,21,22,23]. The use of cisplatin-based chemotherapy concurrently with RT has not been invariably effective.

Methods

Results

Conclusion