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Korean Journal of Obstetrics & Gynecology 2004;47(5):917-923.
Published online May 1, 2004.
Efficacy and Safety of Concurrent Chemoradiotherapy of Paclitaxel and Carboplatin as Adjuvant Therapy after Primary Surgery in High-risk Cervical Cancer.
Hyun Il Cho, Jae Weon Kim, Noh Hyun Park, Yong Sang Song, Soon Beom Kang, Hyo Pyo Lee
1Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Korea.
2Cancer Research Institute, College of Medicine, Seoul National University, Korea.
Abstract
OBJECTIVE
To evaluate the efficacy and safety of concurrent chemotherapy of paclitaxel and carboplatin with standard pelvic radiotherapy as adjuvant therapy after primary surgery in high-risk cervical cancer. METHODS: Twenty-eight patients with FIGO stage IB1-IIB cervical cancer who received adjuvant concurrent chemoradiotherapy with paclitaxel and carboplatin from February 2000 to November 2001 were analyzed retrospectively in this study. Adjuvant chemoradiotherapy was done if there were lymph node involvement or at least 2 positive findings among following risk factors; lymphovascular space invasion, full- thickness involvement of cervix and tumor size larger than 4 cm in diameter. Two cycles of paclitaxel 135 mg/m2, followed by carboplatin with AUC of 4.5 were administered intravenously with an interval of at least 4 weeks. The radiotherapy was initiated concurrently at the first day of chemotherapy. The therapeutic results were evaluated by pelvic examination, Pap smear, SCCA (Squamous cell carcinoma antigen) and computed tomography (CT). The toxicities of the treatment were evaluated and graded by NCI-CTC version 2.0. RESULTS: Total 56 cycles of paclitaxel/carboplatin chemotherapy with concomitant pelvic radiotherapy was delivered. None of the patients had a progressive or recurrent disease during the follow-up period ranging from 6 to 33 months (median: 12.5 months). Neutropenia was the most common and concerned toxicity. Fifteen cases of grade 3 and 4 neutropenia (26.8%) were observed. Non-hematologic toxicities were mild and mainly related to neurologic or gastrointestinal symptoms. Eight cases of grade 1 and 2 neurotoxicity were observed (14.3%). CONCLUSION: The adjuvant chemoradiotherapy with paclitaxel and carboplatin seems to be effective and well-tolerated for the treatment of high risk group cervical cancer after primary surgical therapy. But a large randomized study with longer duration of follow-up is needed to justify this conclusion.
Key Words: Concurrent chemoradiotherapy, Paclitaxel, Carboplatin, Cervical cancer, High-risk
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