Concurrent Chemoradiotherapy With Paclitaxel And Nedaplatin Followed By Consolidation Chemotherapy In Locally Advanced Squamous Cell Carcinoma of the Uterine Cervix: Preliminary Results of a Phase II Study
Received 18 March 2009; received in revised form 31 August 2009; accepted 31 August 2009. published online 08 March 2010. Corrected Proof
Purpose
To evaluate the efficacy and toxicities of concurrent chemoradiotherapy (CCRT) and consolidation chemotherapy in patients with locally advanced squamous cell cervical carcinoma.
Methods and Materials
Patients with LASCC (FIGO Stage IIB–IIIB) were treated with pelvic external beam radiotherapy (45 Gy for Stage IIB and 50 Gy for Stage III) and high-dose-rate intracavitary brachytherapy (50 Gy for Stage IIB and 35 Gy for Stage III). The cumulative dose at point A was 50 Gy for Stage IIB and 65 Gy for Stage III. Concurrent chemotherapy with paclitaxel (35 mg/m2) and nedaplatin (20 mg/m2) was given every week for 6 weeks. Consolidation chemotherapy with paclitaxel (135 mg/m2) and nedaplatin (60 mg/m2) was administered every 3 weeks for 4 cycles.
Results
All patients completed CCRT, and 28 of 34 patients completed consolidation chemotherapy. The complete response rate was 88% (95% CI, 73–96%). The most common Grade 3 or higher toxicities were leukopenia/neutropenia (10.9% of the cycles). During a median follow up of 23 months (range, 14–30 months), 5 patients had locoregional failure and 1 patient had distant metastasis. The estimated 2-year progression-free survival and overall survival were 82% (95% CI, 68–95%) and 93% (95% CI, 83–100%), respectively. Grade 3 late complications occurred in 3 patients (9%).
Conclusions
CCRT with paclitaxel and nedaplatin followed by consolidation chemotherapy is well tolerated and effective in patients with locally advanced squamous cell cervical carcinoma. Further randomized trials of comparing this regimen with the standard treatment are worth while.
Department of Gynecologic Oncology, Cancer Hospital, and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
Reprint requests to: Mei-Qin Zhang, M.D., Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong-an Road, Shanghai 200032, P.R. China. Tel: (86) 21-64175590, ext. 2905; Fax: (86) 21-64174774
Supported by Shanghai Municipality Bureau of Health Grant 034092 (to Mei-Qin Zhang).
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