Randomized clinical trial of weekly vs. triweekly cisplatin-based chemotherapy concurrent with radiotherapy in the treatment of locally advanced cervical cancer
- PMID: 21840137
- DOI: 10.1016/j.ijrobp.2011.05.002
Randomized clinical trial of weekly vs. triweekly cisplatin-based chemotherapy concurrent with radiotherapy in the treatment of locally advanced cervical cancer
Abstract
Purpose: To compare compliance, toxicity, and outcome of weekly and triweekly cisplatin administration concurrent with radiotherapy in locally advanced cervical cancer.
Methods and materials: 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/m(2), six cycles) and triweekly (cisplatin 75 mg/m(2) 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.
Results: 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).
Conclusions: Triweekly cisplatin 75-mg/m(2) chemotherapy concurrent with radiotherapy is more effective and feasible than the conventional weekly cisplatin 40-mg/m(2) regimen and may be a strong candidate for the optimal cisplatin dose and dosing schedule in the treatment of locally advanced cervical cancer.
Copyright © 2011 Elsevier Inc. All rights reserved.
Comment in
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Chemotherapy: Cisplatin more effective when given less often.Nat Rev Clin Oncol. 2011 Sep 6;8(10):568. doi: 10.1038/nrclinonc.2011.136. Nat Rev Clin Oncol. 2011. PMID: 21894206 No abstract available.
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Randomized clinical trial of weekly vs. triweekly cisplatin-based chemotherapy concurrent with radiotherapy in the treatment of locally advanced cervical cancer: in regard to Sang-Young Ryu et al. (Int J Radiat Oncol Biol Phys 2011;81:e577-e581).Int J Radiat Oncol Biol Phys. 2012 Mar 15;82(4):1320. doi: 10.1016/j.ijrobp.2011.11.051. Int J Radiat Oncol Biol Phys. 2012. PMID: 22385715 No abstract available.
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Randomized clinical trial of weekly versus triweekly cisplatin-based chemotherapy concurrent with radiotherapy in treatment of locally advanced cervical cancer: in regard to Ryu et al. (Int J Radiat Oncol Biol Phys 2011;81:e577-e581).Int J Radiat Oncol Biol Phys. 2012 Mar 15;82(4):1320-1. doi: 10.1016/j.ijrobp.2011.12.043. Int J Radiat Oncol Biol Phys. 2012. PMID: 22385716 No abstract available.
