Efficacy of paclitaxel and carboplatin as a regimen for postoperative concurrent chemoradiotherapy of high risk uterine cervix cancer

Objective.: To evaluate the efficacy and safety of concurrent chemoradiotherapy with paclitaxel and carboplatin after hysterectomy for early stage uterine cervical carcinoma with high risk factors. Methods.: Between March 2000 and July 2002, 37 patients with stages IB-IIB uterine cervical carcinoma were treated with radical hysterectomy and bilateral pelvic lymph node dissection followed by concurrent chemoradiotherapy (POCCRT) with two courses of paclitaxel (135 mg/m²) and carboplatin (area under the time-concentration curve 4.5 mg min/ml) at 4-week interval. All the patients received external beam radiotherapy up to 50.4 Gy to the whole pelvis. Among these, 7 patients with close or involved resection margin received boost irradiation to the vaginal cuff (4 patients with low dose rate brachytherapy and 3 patients with external beam). Median dose of boost irradiation was 14.4 Gy (range: 14.4-34.6). Results.: Toxicity to POCCRT was mainly hematological and gastrointestinal, mostly grades 1 and 2. At a median follow-up of 27 months (range; 10-46), all the patients achieved local control, and 4 patients experienced distant relapses. The failure sites were as follows: bone (2 patients), paraaortic lymph node (1 patient), and supraclavicular lymph node (1 patient). Conclusions.: Concurrent chemoradiotherapy with paclitaxel and carboplatin after hysterectomy is well tolerated and produces excellent local control rate despite of short follow-up period. This regimen could be considered for a phase III trial.