Carboplatin-based chemoradiotherapy in advanced cervical cancer: an alternative to cisplatin-based regimen?

Abstract Objective To evaluate the results of treatment with cisplatin or carboplatin concomitant with radiotherapy (RT) in cases of locally advanced cervical cancer (CC). Methods This study is a retrospective analysis of medical records of 184 patients with cervical cancer stage IIB-IVA who were treated at Instituto do Câncer do Estado de Sao Paulo from May 2008 to December 2012. All patients received complete pelvic region external-beam RT with weekly cisplatin (cis-RT, 40 mg/m 2 ; n  = 159) or carboplatin (carbo-RT, AUC 2; n  = 25), followed by high-dose-rate intracavitary brachytherapy (HDR-ICBT). Primary endpoint was progression free survival; secondary endpoints were overall survival and overall response rate, which includes complete and partial responses. Results Five or more chemotherapy cycles were administered to 87.3% and 84% of the cis-RT- and carbo-RT- treated patients, respectively ( p  = 0.749). Estimated 3-years progression free survival was 59% in the cis-RT group vs 40% in the carbo-RT group ( p  = 0.249). Estimated 3-years overall survival was 70% in the cis-RT group vs 68% in the carbo-RT group ( p  = 0.298). Overall response rate (95.3% cis-RT vs 95.4% carbo-RT; p  = 0.911) and grade ≥3 toxic effects (8.5% cis-RT vs 11.8% carbo-RT; p  = 0.757) were similar. In multivariate analysis, only the overall response rate was a significant predictor of survival. Conclusions Patients with advanced cervical cancer who are treated with carbo-RT have similar 3-years overall survival, progression free survival, overall response rate, and toxic effects when compared to cis-RT-treated patients. Carbo-RT may be an alternative treatment in patients that cannot receive cisplatin.