Image Guidance Volume-Modulated Arc Radiation Therapy Concurrently With Nab-Paclitaxel Plus Cisplatin for Patients With Locally Advanced Cervical Cancer: A Single-Arm Dose Escalation Trial

Jiang, Ping; Deng, Xiuwen; Qu, Ang; Wang, Jiang; Guo, Fuxin; Han, Qin; Guo, Hongyan; Wang, Junjie

doi:10.1016/j.ijrobp.2022.11.011

Cited by 6 publications

(5 citation statements)

References 50 publications

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“…It was reported that the recommended dose for nab-paclitaxel was 60 mg/m 2 weekly when given standard weekly concurrent intensity modulated radiation therapy (IMRT) in patients with head and neck squamous cell carcinoma (Suntharalingam et al 2012 ). Jiang et al found that the MTD of nab-paclitaxel was 50 mg/m 2 in locally advanced cervical cancer patients undergoing concurrent radiation therapy with nab-paclitaxel plus cisplatin (40 mg/m 2 ) weekly (Jiang et al 2023 ). In our study, the dose of the nab-paclitaxel we used weekly was 100 mg in CCRT, the body surface area range of nab-paclitaxel group patients was 1.44–1.80 m 2 , which was equal to 55–70 mg/m 2 dose of nab-paclitaxel.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the clinical efficacy and safety of concurrent chemoradiotherapy with cisplatin and nab-paclitaxel in postoperative early-stage cervical cancer

Zhao,

Li,

Chen

et al. 2024

J Cancer Res Clin Oncol

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Objective A preclinical study showed that nab-paclitaxel acted as a radiosensitizer and improved tumor radiotherapy in a supra-additive manner. In this study, we aimed to evaluate the clinical efficacy and safety of concurrent chemoradiotherapy (CCRT) with cisplatin and nab-paclitaxel in postoperative early-stage cervical cancer with an unfavorable prognosis. Methods Eligible patients with stage IB1-IIA2 (FIGO 2009) cervical carcinoma were recruited retrospectively between August 2018 to May 2021. Patients in both the cisplatin and nab-paclitaxel groups received postoperative radiotherapy and weekly intravenous cisplatin 40 mg/m2 or nab-paclitaxel 100 mg concurrently. An analysis of overall survival, progression-free survival, and adverse reactions was conducted. Results A total of 105 early-stage cervical cancer patients were included into our study. The median follow-up time was 38.7 months. The 3-year overall survival and progression-free survival in both group was similar. The cycles of chemotherapy in the cisplatin group were less than those in the nab-paclitaxel group (4.5 vs. 5.0; p = 0.001). Patients in the cisplatin group had a significantly higher frequency of hematological adverse events than patients in the nab-paclitaxel group (P < 0.05). Patients in the cisplatin group had a significantly higher frequency of grade 3–4 leukopenia (46.1% vs. 18.9%; P = 0.03), grade 1–2 thrombocytopenia (32.7% vs. 9.5%; P = 0.014) than patients in the nab-paclitaxel group. Gastrointestinal reactions, such as vomiting, nausea, and anorexia were significantly reduced in the nab-paclitaxel group compared with those in the cisplatin group. Regarding the effects on alopecia, the incidence rate of the nab-paclitaxel group was higher than that of the cisplatin group (P = 0.001). There were no differences between the groups in terms of other adverse reactions. Conclusion The results of this study indicate that nab-paclitaxel-based concurrent radiotherapy is tolerable and effective, and can be considered an alternative to cisplatin chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Evaluating the clinical efficacy and safety of concurrent chemoradiotherapy with cisplatin and nab-paclitaxel in postoperative early-stage cervical cancer

Zhao,

Li,

Chen

et al. 2024

J Cancer Res Clin Oncol

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“…Related studies have further indicated that combination regimens can elevate therapeutic efficacy to levels exceeding 80% [21,22]. Among the commonly utilized platinum drugs, cisplatin and carboplatin stand out, possessing a broad spectrum of anticancer activity [23,24]. Cisplatin's principal advantages are its broad anticancer spectrum, high effectiveness, and others, whereas its main downside is its considerable toxic side effects.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical efficacy of paclitaxel + carboplatin and paclitaxel + cisplatin on tumor markers and WHOQOL-BREF score on cervical cancer patients

2023

EJGO

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This study aims to compare tumor marker indicators, World Health Organization Quality of Life-Brief assessment (WHOQOL-BREF) scores and clinical outcomes between cervical cancer patients treated with paclitaxel + carboplatin versus those treated with paclitaxel + cisplatin. 66 cervical cancer patients admitted to our hospital were randomly selected and allocated equally into a control group (paclitaxel + cisplatin) and a study group (paclitaxel + carboplatin) using a randomized double-blinded approach. Tumor marker indices, WHOQOL-BREF scores, Karnofsky Performance Status (KPS) scores, clinical outcomes and adverse effects were assessed and compared before and after treatment. The study group was found to have lower carcino-embryonic antigen (CEA), Carbohydrate antigen (CA) 199, CA125 and CA50 levels, significantly higher WHOQOL-BREF scores, and significantly higher KPS scores at 7 days, 1 month, 2 months and 3 months post-treatment compared to the control group (all p < 0.05). However, we also observed that while the treatment effectiveness rate in the study group (75.76%) surpassed that in the control group (66.67%), the difference was statistically significant (p > 0.05). Patients in the study group had a statistically significant lower incidence of diarrhea (45.45%) and nausea and vomiting (48.48%) compared to the control group, whose corresponding rates were higher at 69.70% and 75.76%, respectively (χ 2 = 3.969, 5.215, p = 0.046, 0.022). Conversely, the incidence of bone marrow suppression in the study group (48.48%) was significantly higher than that in the control group (21.21%) (χ 2 = 4.405, p = 0.020). We conclude that the combination of paclitaxel and carboplatin was an effective treatment approach for cervical cancer patients, offering comparative advantages over paclitaxel + cisplatin, with reduced tumor marker levels, enhanced quality of life, and minimized adverse reaction occurrence.

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“…Acute grade ≥ 3 GI and GU toxicities occurred in 3% and overall late GI or GU toxicity rate was 12%. In a recent trial testing newer chemotherapeutic agent in adjunction with cisplatin for definitive CCRT, SIB to LN up to 60 Gy is tolerable with complete response in > 90% [ 72 ]. PET/CT has 20%-25% false negative rate for PAN in patients with PET-positive node limited to the pelvis [ 73 , 74 ].…”

Section: Potential Benefitsmentioning

confidence: 99%

Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review

Lee,

Kim,

Lee

et al. 2024

Cancer Res Treat

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Radiotherapy (RT) is a fundamental modality in treatment of cervical cancer. With advancement of technology, conventional RT used for external beam radiotherapy (EBRT) for over half a century has been rapidly replaced with intensity-modulated radiation therapy (IMRT) especially during the last decade. This newer technique is able to differentiate the intensity of radiation within the same field, thus reduces the inevitable exposure of radiation to normal organs and enables better dose delivery to tumors. Recently, the American Society for Radiation Oncology has released a guideline for RT in cervical cancer. Although a section of the guideline recommends IMRT for the purpose of toxicity reduction, a thorough review of the literature is necessary to understand the current status of IMRT in cervical cancer. This narrative review updates the recent high-level evidences regarding the efficacy and toxicity of IMRT and provides a better understanding of the most innovative techniques currently available for EBRT enabled by IMRT.

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Image Guidance Volume-Modulated Arc Radiation Therapy Concurrently With Nab-Paclitaxel Plus Cisplatin for Patients With Locally Advanced Cervical Cancer: A Single-Arm Dose Escalation Trial

Cited by 6 publications

References 50 publications

Evaluating the clinical efficacy and safety of concurrent chemoradiotherapy with cisplatin and nab-paclitaxel in postoperative early-stage cervical cancer

Evaluating the clinical efficacy and safety of concurrent chemoradiotherapy with cisplatin and nab-paclitaxel in postoperative early-stage cervical cancer

Comparison of the clinical efficacy of paclitaxel + carboplatin and paclitaxel + cisplatin on tumor markers and WHOQOL-BREF score on cervical cancer patients

Intensity-Modulated Radiation Therapy for Uterine Cervical Cancer to Reduce Toxicity and Enhance Efficacy – an Option or a Must?: A Narrative Review

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