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Concurrent Chemoradiation with Weekly Paclitaxel and Cisplatin for Locally Advanced Cervical Cancer

  • Kalaghchi, Bita (Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences) ;
  • Abdi, Robab (Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences) ;
  • Amouzegar-Hashemi, Farnaz (Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences) ;
  • Esmati, Ebrahim (Radiation Oncology Research Center, Cancer Institute, Tehran University of Medical Sciences) ;
  • Alikhasi, Afsaneh (Radiology Department, Tehran University of Medical Sciences)
  • Published : 2016.06.01

Abstract

Cervical cancer is one of the most common gynecological cancers in Iranian women. This study was initiated to assess whether the combination of paclitaxel and cisplatin with radiation might feasible for these patients. The aim was to assess tumor response and toxicity of weekly cisplatin and paclitaxel along with radiotherapy in the treatment of cervical cancer. Women with primary untreated squamous cell carcinoma of the cervix with FIGO stages IB2 to IIIB were treated with weekly injections of cisplatin 30 mg/m2 and paclitaxel 35 mg/m2 for 5-6 weeks along with radiotherapy. A total of 25 patients were enrolled in this study who completed the intended treatment. Disease was assessed prior to treatment by pelvic examination and contrast enhanced MRI of the abdomen and pelvis. Response was assessed 1 month after completion of treatment by physical examination and 3 months after also by MRI.Toxicity was assessed and was graded using RTOG grading. There was a complete response rate of 84% after 3 months. The major toxicity was grade 1 and 2 anemia (92%). The mean duration of treatment was 58 days. In conclusion, combination chemotherapy with cisplatin and paclitaxel along with radiotherapy in patients with locally advanced squamous cell carcinoma of cervixwas well tolerated, in contrast to other studies, but it seems that there was no increase in tumor response and progression free survival with this treatment regimen.

Keywords

References

  1. Alvarez AM, Mickiewicz E, Rodger J, et al (2002). Radiotherapy (RT) with low dose biweekly gemcitabine (LDBG) and cisplatin in locally advanced cervical carcinoma (LACC): (stages IIa-IVa). Proc Am Soc Clin Oncol, 21, 892-8.
  2. Belani CP, Aisner J, Bahri S, et al (1996). Chemoradiotherapy in nonsmall- cell lung cancer: Paclitaxel-carboplatin-radiotherapy in regionally advanced disease. Semin Oncol, 23, 113-6.
  3. Britten RA, Perdue S, Opoku J, et al(1998). Taxol is preferentially cytotoxic tohuman cervical tumor cells with low Raf-1 kinase activity: implicationsfor Taxol-based chemoradiation regimens. Radiother Oncol, 48, 329-34. https://doi.org/10.1016/S0167-8140(98)00084-X
  4. Chen MD, Paley PJ, Potish RA, et al(1997) Phase I trial of Taxol as radiation sensitizer with Cisplatin in advanced cervical cancer. Gynecol Oncol, 67, 131-6. https://doi.org/10.1006/gyno.1997.4851
  5. Collaboration (NACCCMA) collaboration. Neoadjuvant chemotherapy for locally advanced cervix cancer. Cochrane Database Syst Rev. (1), http://dx.doi.org/10.1002/14651858. CD001774.pub2 [Art. No.: CD001774].
  6. Conley B, Jacobs M, Suntharalingam M, et al (1997). A pilot trial of paclitaxel, carboplatin and concurrent radiotherapy for unresectable squamous cell carcinoma of the head and neck. Semin Oncol, 24, 78-80.
  7. DiSilvestro PA, Walker JL, Morrison A, et al(2006). Radiation therapy with concomitant paclitaxel and cisplatin chemotherapy in cervical carcinoma limited to the pelvis: a phase I/II study of the Gynecologic Oncology Group. Gynecol Oncol, 103, 1038-42 https://doi.org/10.1016/j.ygyno.2006.06.017
  8. Frasci G, Cornelia P, Scoppa G, et al(1997). Weekly paclitaxel and cisplatin with concurrent radiotherapy in locally advanced non-Downloaded from http://annonc.oxfordjournals.org/ by guest on July 29, 2013459 small-cell lung cancer: A phase I study. J Clin Oncol, 1, 1409-17.
  9. Green JA, Kirwan JM, Tierney JF, et al (2001). Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: A systematic review and meta-analysis. Lancet, 358, 781-86. https://doi.org/10.1016/S0140-6736(01)05965-7
  10. Hashemi FA, Akbari EH, Kalaghchi B, et al(2013). Concurrent chemoradiation with weekly gemcitabine and cisplatin for locally advanced cervical cancer. Asian Pac J Cancer Prev, 14, 5385-89. https://doi.org/10.7314/APJCP.2013.14.9.5385
  11. Hockel M, Schlenger K, Aral B, et al (1996). Association between tumor hypoxia and malignant progression in advanced cancer of the uterine cervix. Cancer Res, 56, 4509-15.
  12. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  13. Keys HM, Bundy BN, Stehman FB, et al (1999). Cisplatin, radiation and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med, 340, 1154-61. https://doi.org/10.1056/NEJM199904153401503
  14. Kudelka AP, Winn R, Edwards CL, et al (1996). Activity of paclitaxel in advanced or recurrent squamous-cell cancer of the cervix. Clin Cancer Res, 2, 1285-8.
  15. Liebmann J, Cook JA, Fisjer J, et al (1994). In vitro studies of Taxol as a radiation sensitizer in human tumor cells. J Natl Cancer Inst, 86, 441-6. https://doi.org/10.1093/jnci/86.6.441
  16. Lucca H, Hirte H, Fyles A, et al (2002). Concurrent cisplatin-based chemotherapy plus radiotherapy for cervical cancer: A metaanalysis. Clin Oncol, 14, 203-12. https://doi.org/10.1053/clon.2002.0076
  17. Miglietta L, Franzone P, Centurioni MG, et al (2006). A phase II trial with cisplatin‑paclitaxel cytotoxic treatment and concurrent external and endocavitary radiation therapy in locally advanced or recurrent cervical cancer. Oncology, 70, 19-24. https://doi.org/10.1159/000091182
  18. Morris M, Eifel PJ, Lu J, et al(1999). Pelvic radiation with concurrent chemotherapy compared with pelvic and paraaortic radiation for high risk cervical cancer. N Engl J Med, 340, 1137-43. https://doi.org/10.1056/NEJM199904153401501
  19. Papadimitriou CA, Sarris K, Moulopoulos LA, et al (1999). Phase II trial of paclitaxel and cisplatin in metastatic and recurrent carcinoma of the uterine cervix. J Clin Oncol, 17, 761-6. https://doi.org/10.1200/JCO.1999.17.3.761
  20. Parkin DM, Bray F, Ferlay J, et al (2005). Global cancer statistics, CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  21. Petera J, Odrazka K, Frgala T, et al(2005). External beam radiotherapy and high-dose brachytherapy combined with cisplatin and paclitaxel in patients with advanced cervical carcinoma. Gynecol Oncol, 99, 334-8. https://doi.org/10.1016/j.ygyno.2005.06.015
  22. Pignata S, De-Vivo R, Ricchi P et al, (1998). Chemotherapy in squamous cell carcinoma of the cervix uteri: Present role and perspectives. Cancer Treat Rev, 24, 27-34. https://doi.org/10.1016/S0305-7372(98)90069-X
  23. Pradier O, Rave-Frank M, Schmidberger H, et al(1999): Effects of paclitaxel in combination with radiation on human head and neck cancer cells (ZMK-1), cervical squamous cell carcinoma (CaSki), and breastadenocarcinoma cells (MCF-7). J Cancer Res Clin Oncol, 125, 20-7. https://doi.org/10.1007/s004320050237
  24. Rose PG, Blessing JA, Gershenson DM, et al(1999). Paclitaxel and cisplatin as first-line therapy in recurrent or advanced squamous carcinoma of the cervix: A Gynaecologic Oncology Group study. J Clin Oncol, 17, 2676-80. https://doi.org/10.1200/JCO.1999.17.9.2676
  25. Rose PG, Bundy BN, Watkins EB, et al(1999). Concurrent cisplatinbased radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med, 340, 1144-153. https://doi.org/10.1056/NEJM199904153401502
  26. Tishler RB, Geard R, Hall EJ et al(1992). Taxol sensitizes human astrocytoma cells to radiation. Cancer Res, 52, 3495-7.
  27. Vale C(2008). Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials. J Clin Oncol, 26, 5802-12. https://doi.org/10.1200/JCO.2008.16.4368
  28. Varghese SS, Ram TS, Pavamani SP, et al (2014). Concurrent chemo-irradiation with weekly cisplatin and paclitaxel in the treatment of locally advanced squamous cell carcinoma of cervix: A phase II study. J Cancer Res Ther, 2, 330-36.
  29. Vogt HG, Martin T, Kolotas C, et al(1997). Simultaneous Taxol and radiotherapy:initial clinical experience in lung cancer and other malignancies. Semin Oncol, 24, 101-5.
  30. Whitney CW, Sause W, Bundy BN, et al(1999). A randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stages IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: A Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol, 17, 1339-48. https://doi.org/10.1200/JCO.1999.17.5.1339

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