The activity of carboplatin and paclitaxel for recurrent cervical cancer after definitive radiotherapy

Objectives. The aim of this study was to evaluate the efficacy of paclitaxel-carboplatin (TC) for recurrent cervical cancer after definitive radiotherapy and to compare the results with non-taxane containing platinum-based chemotherapies (NTP). Methods. The records of 59 consecutive women who had undergone salvage chemotherapy with TC (n = 28) or NTP (historical control, n = 31) for recurrence after definitive radiotherapy were retrospectively reviewed. Primary disease and recurrence data was collected. The activity and toxicity of TC were compared with those of NTP. The response rate and progress ion-free survival (PFS) after recurrence were the main endpoints. Multivariate analysis of prognostic factors for response was performed using the Cox proportional hazards regression model. Survival was calculated using the Kaplan-Meier methods and compared by the log-rank test. Results. Overall, TC was well tolerated with a response rate of 67.9% (5 CR and 14 PR). The median PFS was 7 months for all patients and 10 months for responders. Myelosuppression was the most common toxicity (grade 3 in 16 patients, grade 4 in 5 patients). On the contrary, NTP showed a response rate of 22.6% with median and mean PFS of 0 month and 2 months, respectively. When compared, TC was significantly superior to NTP with regard to its response rate (p = 0.001) and PFS (p<0.0001). Moreover, TC showed significantly higher activity in patients with adenocarcinoma histology. Conclusions. Carboplatin-paclitaxel is active and well tolerated in patients with recurrent cervical cancer after definitive radiotherapy. This combination should be considered as an alternative regimen to cisplatin-paclitaxel in this patient population. (C) 2009 Elsevier Inc. All rights reserved.