Radiation Oncology—Original Article
Radiation with cisplatin or carboplatin for locally advanced cervix cancer: The experience of a tertiary cancer centre
- G Au-Yeung MBBS FRACP; L Mileshkin MBBS MD FRACP; DM Bernshaw MBBS FRANZCR; S Kondalsamy-Chennakesavan MBBS MPH; D Rischin MBBS MD FRACP; K Narayan MBBS MD PhD FRANZCR.
- Conflict of interest: Dr. Kondalsamy-Chennakesavan has received an educational grant from Abbott Australia. All other authors identify no conflict of interest.
Dr George Au-Yeung, Department of Medical Oncology, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Vic. 3002, Australia.
Definitive treatment with concurrent cisplatin and radiation is the standard of care for locally advanced cervix cancer. The optimal management of patients with a contraindication to cisplatin has not been established. We conducted a retrospective audit of concurrent chemotherapy in a cohort of patients with locally advanced cervix cancer.
All patients with locally advanced cervix cancer treated with definitive radiation were entered into a prospective database. Information regarding their demographics, stage, histology, recurrence and survival were recorded. Pharmacy records were reviewed to determine concurrent chemotherapy use.
A total of 442 patients were included in the audit. Two hundred sixty-nine patients received cisplatin, 59 received carboplatin and 114 received no concurrent chemotherapy. Overall survival was significantly improved with the use of concurrent cisplatin compared with radiation alone (adjusted hazard ratio 0.53, P = 0.001), as was disease-free survival and rate of distant failure. The use of carboplatin was not associated with any significant benefit in terms of overall survival or disease-free survival.
The results of this audit are consistent with the known significant survival benefit with concurrent cisplatin chemotherapy. However, there did not appear to be any significant benefit with carboplatin although there were potential confounding factors. The available evidence in the literature would favour the use of non-platinum chemotherapy rather than carboplatin in patients with contraindications to cisplatin.