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

Zhang, Meiqin; Liu, Suping; Xiange, Wang

doi:10.1016/j.ijrobp.2009.08.069

Cited by 40 publications

(32 citation statements)

References 30 publications

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“…In a recent review, providing additional paclitaxel to treatment, extending the chemotherapy course, and selecting a biological target such as anti-VEGF or anti-epidermal growth factor receptor agents are suggested to have a potential role in the management of adenocarcinoma of the cervix (Gien et al , 2010). Finally, as the survival outcomes of patients with risk-weighted surgical score ⩾12.5 is similar to advanced-stage disease, the indication and efficacy of consolidation therapy after postoperative adjuvant treatment needs to be considered in the future (Vrdoljak et al , 2006; Zhang et al , 2010; Choi et al , 2011). …”

Section: Discussionmentioning

confidence: 99%

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

et al. 2013

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Background:Surgical–pathological risk factors were evaluated by weighting the magnitude of significance of multiple risk factors correlating to survival and treatment response in cervical cancer.Methods:Multivariate analysis was performed for survival outcomes entering seven pathological factors obtained from 540 radical hysterectomy specimens in stage IA2-IIB cervical cancer cases. Hazard ratio (HR) in each risk factor was determined, and the sum of HR scores for the corresponding risk factors was determined per case. Survival curves and postoperative treatment response (concurrent chemoradiotherapy (CCRT) vs radiotherapy alone) were evaluated based on the extent of HR-weighted scores.Results:Hazard ratios for risk factors relating to disease-free survival (DFS) was: lympho-vascular space invasion 3.95, nodal metastasis 3.88, adenocarcinoma 3.40, large tumour 2.36, positive margin 1.99, deep stromal invasion 1.29, and parametria invasion 1.21. The HR-weighted scoring method showed a high predictive value for recurrence (area-under-curve 0.836, P<0.001). Hazard ratio-weighted scores were negatively correlated to DFS, and the cases with score ⩾12.5 showed 5-year DFS rate of 23.8%. Tumours with larger score offset the benefits of CCRT over radiotherapy alone for postoperative adjuvant treatment (P<0.001).Conclusion:Surgical–pathological risk factors provide valuable information for survival and management of early-stage cervical cancer when number and significance of risks are weighted.

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Section: Discussionmentioning

confidence: 99%

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

et al. 2013

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“…In order to identify the efficacy and toxicity results of the use of paclitaxel and carboplatin in consolidation chemotherapy after CCR in treating cervical cancer, we compared our current results with those of relevant previous reports where the efficacy and toxicity of consolidation chemotherapy using platinum-based drugs after CCR had been investigated (Table 3) [7-9,18,19]. Although the types of ICRs were different between all the studies evaluated, a previous meta-analysis had concluded there was no difference in efficacy between the high dose rate and low dose rate ICRs [20].…”

Section: Discussionmentioning

confidence: 99%

Phase II Study of Consolidation Chemotherapy after Adjuvant or Primary Concurrent Chemoradiation Using Paclitaxel and Carboplatin to Treat High-Risk Early-Stage or Locally Advanced Cervical Cancer

Kim

et al. 2012

Cancer Res Treat

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PurposeThis study investigated the efficacy and toxicity associated with consolidation chemotherapy using paclitaxel and carboplatin after concurrent chemoradiation (CCR) in cervical cancer patients.Materials and MethodsFrom a total of 37 patients, 19 with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer (group 1) underwent surgery followed by consolidation chemotherapy after CCR, and 18 with stage IIB-IVA disease (group 2) received consolidation chemotherapy after primary CCR. Three cycles of chemotherapy using paclitaxel (135 mg/m2) and carboplatin (AUC 5.0) were administered every 3 weeks for CCR therapy, and three cycles of consolidation chemotherapy using paclitaxel (175 mg/m2) and carboplatin (AUC 5.0) were used every 3 weeks after CCR.ResultsThe complete and partial response rates were 77.8% and 22.2% in group 2. Moreover, the 3-year progression-free and overall survival rates were 62.7% and 90.9% in group 1, and 51.9% and 60% in group 2, respectively. The most common grade 3 or 4 hematologic toxicities observed were leukopenia (group 1, 10.5%; group 2, 13.0%) and neutropenia (group 1, 7.0%; group 2, 14.8%), and grade 3 or 4 diarrhea (group 1, 1.8%) and febrile illness (group 2, 1.9%) were the most frequently observed non-hematologic toxicities. When we compared these results with previous reports, consolidation chemotherapy after CCR using paclitaxel and carboplatin revealed a relatively lower complete response rate (77.8% vs. 87-100%, respectively) and shorter progression-free survival (51.9-62.7% vs. 81-86%, respectively) and overall survival (60-90.9% vs. 81-95%, respectively) in spite of similar toxicity findings.ConclusionDue to low efficacy results, consolidation chemotherapy using paclitaxel and carboplatin after CCR is not a feasible treatment regimen for high-risk early-stage or locally advanced cervical cancer.

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“…CCRT was well tolerated and effective in patients with locally advanced cervical carcinoma (9). Zhang et al reported CCRT with paclitaxel (135 mg/ m 2 ) and nedaplatin (60 mg/ m 2 ) followed by consolidation chemotherapy with FIGO stage IIB-IIIB cervical cancer (20). These authors found that consolidation chemotherapy every 3 weeks for 4 cycles was effective and well tolerated: 31 patients (91%) received more than 3 cycles of consolidation chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant chemotherapy following concurrent chemoradiotherapy for uterine cervical cancer with lymphadenopathy

et al. 2011

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Abstract. The present study aimed to retrospectively evaluate the efficacy and toxicities of adjuvant chemotherapy with paclitaxel and carboplatin (TC) following concurrent cisplatin-based chemoradiation (CCRT) in patients with cervical cancer with lymphadenopathy (N1). A total of 37 patients with FIGO stage IB2-IVA cervical carcinoma with N1 (median age 57 years, range 31-74 years) were enrolled. External beam radiation therapy was followed by high-dose-rate brachytherapy. In cases of suspected para-aortic lymphadenopathy or common iliac lymph node involvement, extended radiotherapy fields were applied. Positive lymph nodes were externally radiated. Cisplatin was administered weekly at a dose of 30 mg/m 2 during external beam radiation therapy. Adjuvant therapy was administered to 17 patients and comprised carboplatin (6 mg/ ml/ min) and paclitaxel (175 mg/m 2 ) administered monthly after CCRT, and repeated every 4 weeks for 3-6 cycles. Over a median 21.5-month follow-up, no significant differences were found in the recurrence rate, progression-free survival, overall survival, or median interval to recurrence with N1 cervical cancer patients between the two groups. Patients with para-aortic lymphadenopathy who received CCRT and adjuvant chemotherapy had a more favorable overall and disease-free survival than those treated with CCRT alone. However, 16/17 patients developed grade 3-4 leukopenia and 14/17 patients developed severe hematologic toxicity during adjuvant chemotherapy. In conclusion, adjuvant chemotherapy consisting of full dose TC therapy after CCRT was not well tolerated in general and exhibited no benefit to N1 cervical cancer patients. However, it may be of therapeutic advantage over CCRT alone in cervical cancer patients with para-aortic lymphadenopathy.

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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

Cited by 40 publications

References 30 publications

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

Phase II Study of Consolidation Chemotherapy after Adjuvant or Primary Concurrent Chemoradiation Using Paclitaxel and Carboplatin to Treat High-Risk Early-Stage or Locally Advanced Cervical Cancer

Adjuvant chemotherapy following concurrent chemoradiotherapy for uterine cervical cancer with lymphadenopathy

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