Randomized Clinical Trial of Weekly vs. Triweekly Cisplatin-Based Chemotherapy Concurrent With Radiotherapy in the Treatment of Locally Advanced Cervical Cancer

• Published in: International journal of radiation oncology, biology, physics Vol. 81; no. 4; pp. e577 - e581
• Main Authors: Ryu, Sang-Young, Lee, Won-Moo, Kim, Kidong, Park, Sang-Il, Kim, Beob-Jong, Kim, Moon-Hong, Choi, Seok-Cheol, Cho, Chul-Koo, Nam, Byung-Ho, Lee, Eui-Don
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.11.2011
• Subjects: Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Brachytherapy; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; CHEMOTHERAPY; Cisplatin - administration & dosage; Cisplatin - adverse effects; CLINICAL TRIALS; Combined Modality Therapy - methods; Drug Administration Schedule; Female; HAZARDS; Hematology, Oncology and Palliative Medicine; Humans; Locally advanced cervical cancer; Medication Adherence; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; NEOPLASMS; PATIENTS; RADIATION DOSES; Radiation-Sensitizing Agents - administration & dosage; Radiation-Sensitizing Agents - adverse effects; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; Radiotherapy Dosage; Sodium Chloride - administration & dosage; Survival Rate; TOXICITY; Tri-weekly cisplatin-based chemoradiation therapy; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - radiotherapy; Tri-weekly cisplatin-based chemoradiation therapy; Locally advanced cervical cancer
• ISSN: 0360-3016; 1879-355X; 1879-355X
• DOI: 10.1016/j.ijrobp.2011.05.002

To compare compliance, toxicity, and outcome of weekly and triweekly cisplatin administration concurrent with radiotherapy in locally advanced cervical cancer. In this open-label, randomized trial, 104 patients with histologically proven Stage IIB–IVA cervical cancer were randomly assigned by a computer-generated procedure to weekly (weekly cisplatin 40 mg/m2, six cycles) and triweekly (cisplatin 75 mg/m2 every 3 weeks, three cycles) chemotherapy arms during concurrent radiotherapy. The difference of compliance and the toxicity profiles between the two arms were investigated, and the overall survival rate was analyzed after 5 years. All patients tolerated both treatments very well, with a high completion rate of scheduled chemotherapy cycles. There was no statistically significant difference in compliance between the two arms (86.3% in the weekly arm, 92.5% in the triweekly arm, p > 0.05). Grade 3–4 neutropenia was more frequent in the weekly arm (39.2%) than in the triweekly arm (22.6%) (p = 0.03). The overall 5-year survival rate was significantly higher in the triweekly arm (88.7%) than in the weekly arm (66.5%) (hazard ratio 0.375; 95% confidence interval 0.154–0.914; p = 0.03). Triweekly cisplatin 75-mg/m2 chemotherapy concurrent with radiotherapy is more effective and feasible than the conventional weekly cisplatin 40-mg/m2 regimen and may be a strong candidate for the optimal cisplatin dose and dosing schedule in the treatment of locally advanced cervical cancer.