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Prediction of Progression-Free Survival and Response to Paclitaxel Plus Carboplatin in Patients With Recurrent or Advanced Cervical Cancer
  1. Takeshi Hisamatsu, MD*,
  2. Seiji Mabuchi, MD, PhD*,
  3. Kiyoshi Yoshino, MD, PhD*,
  4. Masami Fujita, MD, PhD*,
  5. Takayuki Enomoto, MD, PhD*,
  6. Toshimitsu Hamasaki, PhD and
  7. Tadashi Kimura, MD, PhD*
  1. *Departments of Obstetrics and Gynecology, and
  2. Departments of Biomedical Statistics, Osaka University Graduate School of Medicine, Osaka, Japan.
  1. Address correspondence and reprint requests to Seiji Mabuchi, MD, PhD, Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine. 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. E-mail: smabuchi@gyne.med.osaka-u.ac.jp.

Abstract

Objective The aim of this study was to identify predictors of the response to paclitaxel-carboplatin chemotherapy (TC) in recurrent or patients with advanced cervical cancer.

Methods The records of 61 consecutive women with recurrent or advanced cervical cancer who were treated with TC were retrospectively reviewed. Data regarding their primary disease, follow-up, recurrence, and the activity and toxicity of TC were collected. Multivariate analysis was performed using the Cox proportional hazards regression model to identify predictors of the response to TC. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test.

Results Overall, TC was well tolerated and displayed a response rate of 60.7% (19 complete response and 18 partial response). The median progression-free survival was 14 months for all patients and 20 months for the responders. Grade 3 to grade 4 toxicities were observed in 51 patients (83.6%). Multivariate analysis revealed that performance status, symptom status, and prior chemotherapy were independent prognostic predictors of a poor response. Patient survival was inversely correlated with the number of these prognostic factors. When the patients were divided into 2 prognostic groups (low risk: patients with no or one poor prognostic factor; and high-risk: patients with 2 or more poor prognostic factors), the patients in the high-risk group had a significantly shorter progression-free survival than those in the low-risk group (4 vs 16 months, log-rank; P < 0.0001).

Conclusions The combination of paclitaxel and carboplatin is effective in patients with recurrent or advanced cervical cancer. Our prognostic model composed of 3 clinical variables might enable physicians to identify patients who would not derive clinical benefit from TC and offer them the opportunity to receive other types of treatment.

  • Paclitaxel-carboplatin
  • Prognostic factors
  • Recurrent cervical cancer
  • Survival

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Footnotes

  • This work was supported in part by Grant-in-aid for General Scientific Research No 23592446 from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

  • The authors declare that there are no conflicts of interest.

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

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