Which is better? Carboplatin versus cisplatin for locally advanced cervical cancer: Peruvian experience.

Abstract

e17004 Background: Cervical cancer occurs mostly in developing countries, being locally advanced cancer the majority. The standard treatment is chemo-radiation with platinum salts. Carboplatin is commonly used because of its synergy with radiation reported in other malignancies and its safe toxicity profile, besides it is not clear use of it. We want to evaluate the equivalence of cisplatin versus carboplatin concurrent to radiotherapy in terms of response rates and toxicity profile. Methods: Retrospective observational analysis in women older than 18 years old, with diagnosis of locally advanced cervical cancer (stages Ib2 – IVA) at the “Instituto Nacional de Enfermedades Neoplasicas”, Lima – Peru, between 2014 and 2015. We determined two arms; cisplatin 40 mg/m2 per week for 5 weeks and Carboplatin 2AUC per week for 5 weeks. Both groups were given concurrent to radiotherapy. Results: 247 patients were evaluated, 119 received carboplatin and 128 cisplatin. Both groups have similar characteristics; median age was 50 years, the most frequent hystologic type was squamous cell carcinoma in 90.7%, and TNM stage IIB 59.5%, IIIB 27.5% and IV-A 2.8%. The complete response (CR) rate in cisplatin group was of 88.3% and carboplatin group 73.9% (p = 0.004). The toxicity profile was similar in both groups, except to renal toxicity (Cisplatin: 0% vs. Carboplatin: 5%, p = 0.010) and diarrhea (Cisplatin:26.6% vs. Carboplatin: 16.0%, p = 0.043). In patients with CR, the recurrence rate does not present a significant difference according to treatment schedule (Cisplatin: 15.9% vs. Carboplatin: 13.6%, p = 0.651). Overall survival (OS) and disease free survival (DFS) are on going. Conclusions: Our study found that cisplatin had better response rates than carboplatin with similar toxicity profile. This intervention to be remains to be clarified with following-up.