Combined chemoradiation of cisplatin versus carboplatin in cervical carcinoma: a single institution experience from Thailand

Abstract

BackgroundTo report the results of combined chemoradiation (CCRT) with cisplatin versus carboplatin in locally advanced cervical carcinoma.MethodsFrom 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.ResultsTwo-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.ConclusionCarboplatin 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.

Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

“…114,135 Concurrent carboplatin (preferred if cisplatin intolerant) or non-platinum chemoradiation regimens are options for patients who may not tolerate cisplatin-containing chemoradiation. 131,[136][137][138][139][140][141] Carboplatin has been added to the guidelines as a preferred radiosensitizing agent for patients who are cisplatin intolerant.…”

Renal function impairment in cervical cancer patients treated with cisplatin-based chemoradiation: A review of medical records in a Zimbabwean outpatient department

“…The mean percentage reduction in eGFR from baseline was -19% (95% CI: -25.9% to -13.2%) for all patients, and the prevalence of renal impairment in the study population was 43.1%. The prevalence of renal impairment in this population was slightly higher than the 18–35% observed for cervical cancer patients in Thailand and Japan [ 9 , 10 ]. In South Africa, the prevalence of renal toxicity in a similar group of patients receiving CCRT was only 17% [ 21 ].…”

“…Cisplatin is a known cause of AKI, and prevalence of cisplatin-induced nephrotoxicity (CIN) in cervical cancer ranges from 18–35% [ 9 , 10 ]. Risk factors for CIN include age ≥50 years, higher baseline estimated glomerular filtration rate (eGFR), hypoalbuminaemia, hypertension, locally advanced disease with hydronephrosis, cumulative cisplatin dose and lack of prehydration with magnesium [ 9 , 11 , 12 ].…”

Carboplatin and vincristine neurotoxicity in the treatment of pediatric low‐grade gliomas

“…In polytherapy and at high concentration, carboplatin can cause peripheral neuropathy by damaging the DNA in sensory neurons . However, the administration of carboplatin is usually limited by its bone marrow suppressive effect . The most important documented neurological side effect of platinum‐based therapy is hearing loss which is usually seen with cisplatin, but has also been reported in young children treated with high‐dose carboplatin …”

“…8 However, the administration of carboplatin is usually limited by its bone marrow suppressive effect. 9 The most important documented neurological side effect of platinum-based therapy is hearing loss which is usually seen with cisplatin, but has also been reported in young children treated with high-dose carboplatin. [10][11][12] Despite the fact that CV therapy is widely used for pediatric patients with LGG, no study has reported detailed neurological adverse events and outcome of this treatment regimen.…”