Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University.
Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China.
Int J Gynecol Cancer. 2018 Jun;28(5):1029-1037. doi: 10.1097/IGC.0000000000001265.
The aim of this study was to evaluate the efficacy of using nedaplatin to replace cisplatin for concurrent chemoradiotherapy (CCRT) in patients with newly diagnosed locally advanced cervical cancer.
The medical records of 155 patients with cervical cancer who had undergone CCRT with cisplatin (n = 85) or nedaplatin (n = 70) between January 2012 and January 2017 were retrospectively reviewed. Propensity score analysis with 1:1 matching with the nearest neighbor matching method was performed to assess response rates, progression-free survival, overall survival, and toxicity between 2 groups.
Propensity score matching identified 63 patients in each group. After matching, compared with patients treated with cisplatin-based concurrent chemoradiotherapy (CisRT), we found that patients treated with nedaplatin-based concurrent chemoradiotherapy (NedaRT) had a significant higher recurrence rate (25.4% vs 42.9%; P = 0.04). In addition, the 3-year progression-free survival rate for NedaRT group was also worse than that for the CisRT group (52.2% vs 63.4%, P = 0.03). There was no difference in the overall response rates between the CisRT and NedaRT groups (87.3% and 90.5%, respectively; P = 0.57). The rates of 3-year overall survival and grades 3 to 4 toxicities were similar between the 2 groups.
The clinical outcome of this cohort of patients with locally advanced cervical cancer treated with CCRT did in no way provide support for the use of nedaplatin in place of cisplatin in chemoradiation and demonstrated no equivalence of the 2 drugs. Cautions should be taken for the replacement among platinum complexes in cancer treatment.
本研究旨在评估使用奈达铂替代顺铂进行同期放化疗（CCRT）治疗新诊断的局部晚期宫颈癌患者的疗效。
回顾性分析了 2012 年 1 月至 2017 年 1 月期间接受顺铂（n=85）或奈达铂（n=70）同期放化疗的 155 例宫颈癌患者的病历。采用 1：1 倾向性评分匹配最近邻匹配法对两组患者的反应率、无进展生存期、总生存期和毒性进行评估。
倾向性评分匹配后，每组各有 63 例患者。与接受顺铂为基础的同期放化疗（CisRT）的患者相比，接受奈达铂为基础的同期放化疗（NedaRT）的患者复发率显著更高（25.4%比 42.9%，P=0.04）。此外，NedaRT 组的 3 年无进展生存率也比 CisRT 组差（52.2%比 63.4%，P=0.03）。CisRT 组和 NedaRT 组的总体缓解率无差异（分别为 87.3%和 90.5%，P=0.57）。两组 3 年总生存率和 3-4 级毒性发生率相似。
本队列局部晚期宫颈癌患者接受 CCRT 的临床结果并未为奈达铂替代顺铂在放化疗中的应用提供支持，也未能证明这两种药物具有等效性。在癌症治疗中，铂类药物的替代应慎重。
