Survival and toxicity differences between 5-day and weekly cisplatin in patients with locally advanced cervical cancer

Mark H. Einstein, Akiva P. Novetsky, Madhur K. Garg, Susan M. Hailpern, Gloria S. Huang, Arielle Glueck, Abbie L. Fields, Shalom Kalnicki, Gary L. Goldberg

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

BACKGROUND. Cisplatin (CDDP) administration concomitant with radiotherapy (RT) for the treatment of locally advanced cervical cancer has evolved from an inpatient 5-day every 21-day regimen to a weekly outpatient regimen. This study was designed to test for differences in progression-free survival (PFS) and toxicity between the 2 regimens. METHODS. In all, 77 consecutive patients at a single institution with stage IB2-IV cervical cancer were included in this analysis (using the International Federation of Gynecologists and Obstetricians staging system). All patients were treated with CDDP, external beam RT, and 2 9-Gy high-dose-rate brachytherapy treatments. Two cohorts were compared: 1) 5-day, patients treated from 1995 to 2001 with CDDP 20 mg/m2 x 5 days every 21 days concomitant with RT; 2) weekly, treated after May 2001 with CDDP 40 mg/m2 weekly concomitant with RT. RESULTS. In all, 50 patients were treated with the 5-day regimen and 27 patients with the weekly regimen. There were no significant demographic differences between the groups. Overall 3-year PFS, controlling for stage, was 90% and 76% for 5-day and weekly groups, respectively (P = .01). Adjusting for stage, age, and completion of treatment, the risk of treatment failure among the weekly group was 3.46 times higher than the 5-day group (P = .02). The weekly group had a 3.43 times higher risk of developing acute toxicities than the 5-day group (P = .02) in advanced-stage patients. CONCLUSIONS. Patients who received weekly CDDP have a shorter 3-year PFS. Patients with advanced-stage cervical cancer who received weekly CDDP had significantly more acute toxicities. These data should be confirmed in a multiinstitutional, randomized, controlled study.

Original languageEnglish (US)
Pages (from-to)48-53
Number of pages6
JournalCancer
Volume109
Issue number1
DOIs
StatePublished - Jan 1 2007

Fingerprint

Uterine Cervical Neoplasms
Cisplatin
Survival
Radiotherapy
Disease-Free Survival
Brachytherapy
Treatment Failure
Inpatients
Outpatients
Therapeutics
Demography

Keywords

  • CDDP
  • Cervical carcinoma
  • Cisplatin
  • Concomitant chemoradiotherapy
  • HDR
  • High-dose rate brachytherapy
  • Radiotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Einstein, M. H., Novetsky, A. P., Garg, M. K., Hailpern, S. M., Huang, G. S., Glueck, A., ... Goldberg, G. L. (2007). Survival and toxicity differences between 5-day and weekly cisplatin in patients with locally advanced cervical cancer. Cancer, 109(1), 48-53. https://doi.org/10.1002/cncr.22369

Survival and toxicity differences between 5-day and weekly cisplatin in patients with locally advanced cervical cancer. / Einstein, Mark H.; Novetsky, Akiva P.; Garg, Madhur K.; Hailpern, Susan M.; Huang, Gloria S.; Glueck, Arielle; Fields, Abbie L.; Kalnicki, Shalom; Goldberg, Gary L.

In: Cancer, Vol. 109, No. 1, 01.01.2007, p. 48-53.

Research output: Contribution to journalArticle

Einstein, MH, Novetsky, AP, Garg, MK, Hailpern, SM, Huang, GS, Glueck, A, Fields, AL, Kalnicki, S & Goldberg, GL 2007, 'Survival and toxicity differences between 5-day and weekly cisplatin in patients with locally advanced cervical cancer', Cancer, vol. 109, no. 1, pp. 48-53. https://doi.org/10.1002/cncr.22369
Einstein, Mark H. ; Novetsky, Akiva P. ; Garg, Madhur K. ; Hailpern, Susan M. ; Huang, Gloria S. ; Glueck, Arielle ; Fields, Abbie L. ; Kalnicki, Shalom ; Goldberg, Gary L. / Survival and toxicity differences between 5-day and weekly cisplatin in patients with locally advanced cervical cancer. In: Cancer. 2007 ; Vol. 109, No. 1. pp. 48-53.
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abstract = "BACKGROUND. Cisplatin (CDDP) administration concomitant with radiotherapy (RT) for the treatment of locally advanced cervical cancer has evolved from an inpatient 5-day every 21-day regimen to a weekly outpatient regimen. This study was designed to test for differences in progression-free survival (PFS) and toxicity between the 2 regimens. METHODS. In all, 77 consecutive patients at a single institution with stage IB2-IV cervical cancer were included in this analysis (using the International Federation of Gynecologists and Obstetricians staging system). All patients were treated with CDDP, external beam RT, and 2 9-Gy high-dose-rate brachytherapy treatments. Two cohorts were compared: 1) 5-day, patients treated from 1995 to 2001 with CDDP 20 mg/m2 x 5 days every 21 days concomitant with RT; 2) weekly, treated after May 2001 with CDDP 40 mg/m2 weekly concomitant with RT. RESULTS. In all, 50 patients were treated with the 5-day regimen and 27 patients with the weekly regimen. There were no significant demographic differences between the groups. Overall 3-year PFS, controlling for stage, was 90{\%} and 76{\%} for 5-day and weekly groups, respectively (P = .01). Adjusting for stage, age, and completion of treatment, the risk of treatment failure among the weekly group was 3.46 times higher than the 5-day group (P = .02). The weekly group had a 3.43 times higher risk of developing acute toxicities than the 5-day group (P = .02) in advanced-stage patients. CONCLUSIONS. Patients who received weekly CDDP have a shorter 3-year PFS. Patients with advanced-stage cervical cancer who received weekly CDDP had significantly more acute toxicities. These data should be confirmed in a multiinstitutional, randomized, controlled study.",
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AU - Novetsky, Akiva P.

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AU - Huang, Gloria S.

AU - Glueck, Arielle

AU - Fields, Abbie L.

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N2 - BACKGROUND. Cisplatin (CDDP) administration concomitant with radiotherapy (RT) for the treatment of locally advanced cervical cancer has evolved from an inpatient 5-day every 21-day regimen to a weekly outpatient regimen. This study was designed to test for differences in progression-free survival (PFS) and toxicity between the 2 regimens. METHODS. In all, 77 consecutive patients at a single institution with stage IB2-IV cervical cancer were included in this analysis (using the International Federation of Gynecologists and Obstetricians staging system). All patients were treated with CDDP, external beam RT, and 2 9-Gy high-dose-rate brachytherapy treatments. Two cohorts were compared: 1) 5-day, patients treated from 1995 to 2001 with CDDP 20 mg/m2 x 5 days every 21 days concomitant with RT; 2) weekly, treated after May 2001 with CDDP 40 mg/m2 weekly concomitant with RT. RESULTS. In all, 50 patients were treated with the 5-day regimen and 27 patients with the weekly regimen. There were no significant demographic differences between the groups. Overall 3-year PFS, controlling for stage, was 90% and 76% for 5-day and weekly groups, respectively (P = .01). Adjusting for stage, age, and completion of treatment, the risk of treatment failure among the weekly group was 3.46 times higher than the 5-day group (P = .02). The weekly group had a 3.43 times higher risk of developing acute toxicities than the 5-day group (P = .02) in advanced-stage patients. CONCLUSIONS. Patients who received weekly CDDP have a shorter 3-year PFS. Patients with advanced-stage cervical cancer who received weekly CDDP had significantly more acute toxicities. These data should be confirmed in a multiinstitutional, randomized, controlled study.

AB - BACKGROUND. Cisplatin (CDDP) administration concomitant with radiotherapy (RT) for the treatment of locally advanced cervical cancer has evolved from an inpatient 5-day every 21-day regimen to a weekly outpatient regimen. This study was designed to test for differences in progression-free survival (PFS) and toxicity between the 2 regimens. METHODS. In all, 77 consecutive patients at a single institution with stage IB2-IV cervical cancer were included in this analysis (using the International Federation of Gynecologists and Obstetricians staging system). All patients were treated with CDDP, external beam RT, and 2 9-Gy high-dose-rate brachytherapy treatments. Two cohorts were compared: 1) 5-day, patients treated from 1995 to 2001 with CDDP 20 mg/m2 x 5 days every 21 days concomitant with RT; 2) weekly, treated after May 2001 with CDDP 40 mg/m2 weekly concomitant with RT. RESULTS. In all, 50 patients were treated with the 5-day regimen and 27 patients with the weekly regimen. There were no significant demographic differences between the groups. Overall 3-year PFS, controlling for stage, was 90% and 76% for 5-day and weekly groups, respectively (P = .01). Adjusting for stage, age, and completion of treatment, the risk of treatment failure among the weekly group was 3.46 times higher than the 5-day group (P = .02). The weekly group had a 3.43 times higher risk of developing acute toxicities than the 5-day group (P = .02) in advanced-stage patients. CONCLUSIONS. Patients who received weekly CDDP have a shorter 3-year PFS. Patients with advanced-stage cervical cancer who received weekly CDDP had significantly more acute toxicities. These data should be confirmed in a multiinstitutional, randomized, controlled study.

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