Cisplatin and paclitaxel concomitant with radiotherapy in locally recurrent cancer cervix

ABSTRACT

Twenty-three eligible patients with locally recurrent cervical carcinoma after radical hysterectomy were treated with concomitant cisplatin/paclitaxel and radiation. Thechemotherapy regimen consisted of cisplatin [20 mg/m2] and paclitaxel [45 mg/m2 therapy] that were given every other week concomitantly with 65-70 Gy local pelvic irradiation over 7 weeks. Eight patients [34.8%] experienced grade 3-4 acute toxicity during treatment. Late morbidity was reported in 4 patients [17.4%]. The chemotherapy related morbidity included mainly hematological toxicity, nausea and vomiting and neurotoxicity. The radiation related morbidity included mainly skin reaction, prostatitis and cystitis. Objective response was achieved in 69.7% ofpatients [34.8% complete response and 34.8% partial response]. The median duration of follow up for whole group was 17.1 months. Sex patients [26.9%] were alive with no evidence of disease with a median survival of 30.6 months. The 2 year overall survival was 26.9%. Five patients [21.7%] developed distant metastases. There was a tendency towards better results for earlier initial stage of the disease, patients older than 50 years old, squamous cell carcinoma tumors, tumors < 5 cm, central pelvis tumors and disease free interval from initial surgery more than 1 year. The study concluded that concomitant cisplatin/paclitaxel and radiation is a safe and tolerable treatment with reasonable response rate and satisfying survival for locally recurrent cancer cervix. However, this regimen must be run on a larger number of patients with a longer follow up period to get significant predictors of the response and survival and to guide in identifying the subset of patients that may benefit from more aggressive therapy