Long-term Outcomes of Concurrent Chemoradiotherapy
with Weekly Carboplatin in Locally-Advanced
Carcinoma of the Uterine Cervix Patients
Somphob Sangkittipaiboon MD*
Affiliation :
* Lopburi Cancer Hospital, Department of Medical Service, Ministry of Public Health, Lopburi, Thailand
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.
Material and Method: 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 3.8%). 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.
Conclusion : 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.
Keywords : Toxicities, Response, Recurrence, Disease-free survival rate, Overall survival rate
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