Palliative chemotherapy in carcinoma penis: does platinum and taxane combination holds a promise?

To report safety and efficacy of chemotherapy incorporating the combination of paclitaxel and platinum in patients with advanced penile carcinoma. Retrospective analysis of patient with advanced penile carcinoma undergoing palliative chemotherapy with paclitaxel and platinum combination. The demographic profile, indication of treatment, chemotherapy details, toxicity and survival outcome were noted. Statistical analysis was done for estimation of progression free survival and overall survival. Factors affecting these outcomes were sought for. Eighteen patients with a median age of 47.5 years [31-68 years] were offered palliative intent chemotherapy over a period of 2.5 years. ECOG performance was 1 in 12 patients [66.7%] and 2 in 6 patients [33.3%].The grade of tumor was poorly differentiated in 8 patients [44.4%], moderately differentiated in 5 [27.8%] and we1l differentiated in 5 patients [27.8%]. Twelve patients had previous surgical treatment [66.7%], with 2 of them having received groin radiation in past. The indication for treatment was metastatic disease in 7 patients [38.9%] and locally advanced disease in 11 patients [61.1%]. Out of 18 patients 13 received chemotherapy. Paclitaxel and carboplatin combination was given in 10 patients [76.9%] while paclitaxel and cisplatin was received by 3 patients [23.1%]. The median numbers of cycles received were 3 [1-6 cycles]. Response rate was 30.8%. The median estimated progression free survival [PFS] and overall survival [OS] for patients receiving atleast one cycle of chemotherapy [n = 13] were 96 days and 246 days respectively. Among tested variables the median OS in patients who had received 2 or more cycles was 351 days versus 55 days in those who received less than 2 cycles [P = 0.025]. However, after applying Bonferroni correction, the difference was no longer significant. There was no toxicity related death or life threatening complication. Our institutional protocol of platinum-based doublet with paclitaxel is effective, well-tolerated and has the advantage being delivered on an outpatient basis alone. Overall, we believe that paclitaxel-platinum is an effective regimen that needs to be investigated further in larger studies

Role of paclitaxel and platinum-based adjuvant chemotherapy in high-risk penile cancer

To study the efficacy and safety of paclitaxel and platinum doublet chemotherapy in penile cancer patients with high-risk features of local failure. Retrospective analysis was done of patients with 19 carcinoma of the penis who were offered adjuvant chemotherapy with paclitaxel and platinum combination. The data regarding the surgical details, high-risk features for which chemotherapy was offered, chemotherapy toxicity details [in accordance with CTCAE vs 3], failure pattern, and survival data were noted. SPSS version 16 was used for statistical analysis. Descriptive and Kaplan-Meier survival analysis was performed. Median age of patients was 48 years. Fifteen patients received paclitaxel in combination with cisplatin and four received paclitaxel with carboplatin in view of their low serum creatinine clearance. The treatment was completed by 12 patients [63.2%]. Of 79 planned cycles, 50 were taken. The treatment was well tolerated with grade 3-4 gastrointestinal toxicity was seen in 1 patient, grade 3 neurological toxicity in one and grade 5 neutropenia in one patient. Treatment related death occured in one patient. The median follow-up was 15.33 months and 6 loco-regional relapsed had taken place. The estimated median DFS was 16.2 months and the estimated median OS was not reached. The estimated DFS for treatment completed patients was 23.13 months as against 2.16 months for patients not completing treatment. The platinum and taxane doublet chemotherapy was found to be safe and effective