Effect of concurrent chemoradiation with cisplatin versus concurrent chemoradiation with carboplatin in locally advanced carcinoma cervix: A quasi-experimental study
DOI:
https://doi.org/10.3329/bsmmuj.v18i2.77007Keywords:
carboplatin, cisplatin, concurrent chemoradiotherapy, locally advanced carcinoma cervixAbstract
Background: The standard approach for locally advanced cervical cancer is concurrent chemoradiation with platinum agents, preferably cisplatin. This study was aimed at comparing the treatment response and toxicity of carboplatin-based versus cisplatin-based concurrent chemoradiation in locally advanced carcinoma of the cervix.
Methods: This quasi-experimental study was conducted from September 2022 to August 2023 on 80 patients with locally advanced carcinoma cervix. Patients were divided evenly between the two arms (40 in each Arm). Arm A received weekly cisplatin 40 mg/m2, Arm B received weekly carboplatin with an area under the curve equal to 2 during external beam radiation. Then all the patients in both arms were treated by intracavity brachytherapy. Each patient was evaluated weekly during treatment and three months after the completion to assess treatment response and treatment related acute toxicities.
Results: After three months of completion of treatment, the response was statistically similar between arms [Arm A, 35 (87.5%) versus Arm B, 37 (92.5%), P=0.71]. In terms of toxicity, while Arm B had significantly less anaemia (P=0.03), vomiting (P=0.05), and renal toxicity (P=0.03) than Arm A. Other toxicities such as leucopenia, thrombocytopenia, nausea, hyponatremia, radiation-induced dermatitis, cystitis, proctitis, and diarrhea were similar between arms.
Conclusion: Concurrent chemoradiotherapy with carboplatin had a similar therapeutic response to concurrent chemoradiotherapy with cisplatin in locally advanced cervical cancer. Furthermore, the carboplatin arm had lesser toxicity than the cisplatin arm in terms of anaemia, vomiting, and renal toxicity.
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References
Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, Arbyn M, Basu P, Bray F, Vaccarella S. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2023 Feb;11(2):e197-e206. doi: https://doi.org/10.1016/S2214-109X(22)00501-0
National Institute of Cancer Research and Hospital. Hospital cancer registry report (2018-2020). 2022. URL: https://nicrh.gov.bd/images/reports/41272-hbcr-2018-2020-report_compressed.pdf. Accessed on: 6 May 2025.
DeVita VT Jr, Rosenberg SA, Lawrence TS. DeVita, Hellman, and Rosenberg’s cancer: Principles and practice of oncology. 11th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2019. URL: https://oncology.lwwhealthlibrary.com/book.aspx?bookid=2549. Accessed on: 6 May 2025.
Monk BJ, Tan DSP, Hernández Chagüi JD, Takyar J, Paskow MJ, Nunes AT, Pujade-Lauraine E. Proportions and incidence of locally advanced cervical cancer: a global systematic literature review. Int J Gynecol Cancer. 2022 Dec 5;32(12):1531-1539. doi: https://doi.org/10.1136/ijgc-2022-003801
Anika AS, Bari MA, Alam S, Mollah MNU, Bhuiyan MZR, Sharmin S, Ruma RS, Islam MH, Talukdhar SK. Association of clinico-epidemiological features with locally advanced stage of cervical cancer patients presenting at Bangabandhu Sheikh Mujib Medical University, Bangladesh: Clinicoepidemiological features of locally advanced cervical cancer. Bangabandhu Sheikh Mujib Med Univ J. 2023;15(3):175–179. doi: http://dx.doi.org/10.3329/bsmmuj.v15i3.63038
National Comprehensive Cancer Network. National Comprehensive Cancer Network guideline. 2022. URL: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1426. Accessed on: 6 May 2025.
Eifel PJ, Winter K, Morris M, Levenback C, Grigsby PW, Cooper J, Rotman M, Gershenson D, Mutch DG. Pelvic irradiation with concurrent chemotherapy versus pelvic and para-aortic irradiation for high-risk cervical cancer: an update of radiation therapy oncology group trial (RTOG) 90-01. J Clin Oncol. 2004 Mar 1;22(5):872-880. doi: https://doi.org/10.1200/JCO.2004.07.197
Stehman FB, Ali S, Keys HM, Muderspach LI, Chafe WE, Gallup DG, Walker JL, Gersell D. Radiation therapy with or without weekly cisplatin for bulky stage 1B cervical carcinoma: follow-up of a Gynecologic Oncology Group trial. Am J Obstet Gynecol. 2007 Nov;197(5):503.e1-6. doi: https://doi.org/10.1016/j.ajog.2007.08.003
Chu E, DeVita VT Jr. Physicians’ cancer chemotherapy drug manual 2024. 24th ed. Sudbury, MA: Jones and Bartlett; 2024. URL: https://www.jblearning.com/catalog/productdetails/9781284000009. Accessed on: 6 May 2025.
Tharavichitkul E, Lorvidhaya V, Kamnerdsupaphon P, Sukthomya V, Chakrabandhu S, Klunklin P, Onchan W, Supawongwattana B, Pukanhaphan N, Galalae R, Chitapanarux I. Combined chemoradiation of cisplatin versus carboplatin in cervical carcinoma: a single institution experience from Thailand. BMC Cancer. 2016 Jul 19;16:501. doi: https://doi.org/10.1186/s12885-016-2558-9
Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000 Feb 2;92(3):205-216. doi: https://doi.org/10.1093/jnci/92.3.205
Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1341-1346. doi: https://doi.org/10.1016/0360-3016(95)00060-C
Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, Clarke-Pearson DL, Insalaco S. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999 Apr 15;340(15):1144-1153. doi: https://doi.org/10.1056/NEJM199904153401502
Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE, Rotman M, Gershenson DM, Mutch DG. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999 Apr 15;340(15):1137-1143. doi: https://doi.org/10.1056/NEJM199904153401501
Whitney CW, Sause W, Bundy BN, Malfetano JH, Hannigan EV, Fowler WC Jr, Clarke-Pearson DL, Liao SY. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol. 1999 May;17(5):1339-1348. doi: https://doi.org/10.1200/JCO.1999.17.5.1339
Nam EJ, Lee M, Yim GW, Kim JH, Kim S, Kim SW, Kim JW, Kim YT. Comparison of carboplatin- and cisplatin-based concurrent chemoradiotherapy in locally advanced cervical cancer patients with morbidity risks. Oncologist. 2013;18(7):843-849. doi: https://doi.org/10.1634/theoncologist.2012-0455
Sebastião AM, da Silva Rocha LS, Gimenez RD, de Barros LA, Fukushima JT, da Silva SC, da Costa Miranda V, de Souza Caires IQ, de Freitas D, Filho EA, Diz Mdel P. Carboplatin-based chemoradiotherapy in advanced cervical cancer: an alternative to cisplatin-based regimen? Eur J Obstet Gynecol Reprod Biol. 2016 Jun;201:161-5. doi: https://doi.org/10.1016/j.ejogrb.2016.03.016
Valdiviezo N, Poma Nieto N, Paitan Amaro V, Rabanal C, Vasquez Chavez JF, Mas L. Which is better? Carboplatin versus cisplatin for locally advanced cervical cancer chemo-radiation: Peruvian experience. J Clin Oncol. 2016;34(15_suppl):e17018–e17018. doi: http://dx.doi.org/10.1200/jco.2016.34.15_suppl.e17018
Katanyoo K, Tangjitgamol S, Chongthanakorn M, Tantivatana T, Manusirivithaya S, Rongsriyam K, Cholpaisal A. Treatment outcomes of concurrent weekly carboplatin with radiation therapy in locally advanced cervical cancer patients. Gynecol Oncol. 2011 Dec;123(3):571-576. doi: https://doi.org/10.1016/j.ygyno.2011.09.001
Kim PY, Seo HS, Shin JO, Jang KT, Bae DH. A Comparative Study of the Toxicity Between carboplatin and Cisplatin in VBP Combination Chemotherapy. Korean J Gynecol Oncol Colposc. 1996 Sep;7(3):189-198. doi: https://doi.org/10.3802/kjgoc.1996.7.3.189
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Copyright (c) 2025 Syed Md. Asadul Hoque, Uday Kumar Sarkar, Mohammad Rahamatullah, Newton Kumar Sarker, Md Jamal Uddin, Md Abdul Bari
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