Tharavichitkul Ekkasit, Lorvidhaya Vicharn, Kamnerdsupaphon Pimkhuan, Sukthomya Vimol, Chakrabandhu Somvilai, Klunklin Pitchayaponne, Onchan Wimrak, Supawongwattana Bongkoch, Pukanhaphan Nantaka, Galalae Razvan, Chitapanarux Imjai
The Division of Therapeutic Radiology and Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Faculty of Medicine, Christian-Albrechts-University, Kiel, Germany.
BMC Cancer. 2016 Jul 19;16:501. doi: 10.1186/s12885-016-2558-9.
To report the results of combined chemoradiation (CCRT) with cisplatin versus carboplatin in locally advanced cervical carcinoma.
From 2009 to 2013, 255 patients with stage IIB-IVA cervical carcinoma, according to FIGO staging were prospectively assigned to be treated with pelvic radiotherapy followed by brachytherapy given concurrently with cisplatin or carboplatin in the treatment of locally advanced cervical cancer. Treatment outcomes and toxicitiy were evaluated.
Two-hundred and thirteen patients could be evaluated. At a median follow-up time of 43 months (6-69 months), the 3-year local control, disease-free survival, metastasis-free survival and overall survival rates were 93, 80.8, 85.0 and 87.3 %, respectively. No statistical difference in terms of local control, disease-free survival, metastasis-free survival and overall survival rates between cisplatin and carboplatin treatments was observed in this study. Eighty-six percents of the patients in the carboplatin group could receive more than 4 cycles, while there were only 72 % in the cisplatin group who completed more than 4 cycles (p = 0. 02). In terms of acute toxicity, cisplatin caused significantly more anemia (p = 0.026), neutropenia (p = 0. 044) and nephrotoxicity (p = 0. 031) than carboplatin. No difference in late toxicity was observed in this study.
Carboplatin yielded comparable results to cisplatin in concurrent chemo-radiation for locally advanced cervical cancer. In addition, carboplatin was associated with a better compliance rate and was associated with less of anemia, neutropenia and nephrotoxicity.
报告顺铂与卡铂同步放化疗（CCRT）治疗局部晚期宫颈癌的结果。
2009年至2013年，根据国际妇产科联盟（FIGO）分期，255例IIB-IVA期宫颈癌患者被前瞻性地分配接受盆腔放疗，随后在局部晚期宫颈癌治疗中同步给予顺铂或卡铂近距离放疗。评估治疗结果和毒性。
213例患者可进行评估。中位随访时间为43个月（6 - 69个月），3年局部控制率、无病生存率、无转移生存率和总生存率分别为93%、80.8%、85.0%和87.3%。本研究中，顺铂和卡铂治疗在局部控制率、无病生存率、无转移生存率和总生存率方面未观察到统计学差异。卡铂组86%的患者能够接受超过4个周期的治疗，而顺铂组只有72%的患者完成了超过4个周期的治疗（p = 0.02）。在急性毒性方面，顺铂导致的贫血（p = 0.026）、中性粒细胞减少（p = 0.044）和肾毒性（p = 0.031）明显多于卡铂。本研究中未观察到晚期毒性的差异。
在局部晚期宫颈癌同步放化疗中，卡铂与顺铂疗效相当。此外，卡铂的依从率更高，且贫血、中性粒细胞减少和肾毒性较少。
