Management of Recurrent or Residual Cervical Cancer with Cisplatin and Topotecan Combination Therapy in a Palliative Setting: A Prospective Study
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Treatment options for patients with recurrent or residual cervical tumour are limited. Several new cytotoxic drugs have been recently investigated, comparing single agent with multiple drugs combination. The uses of chemotherapy in these cases are considered palliative because of low response rates and a negligible impact on long-term survival.
Aims and Objectives
To evaluate the efficacy and side effects of cisplatin plus topotecan combined chemotherapy in persistent or recurrent cervical cancer not amenable to curative treatment by surgery and/or radiation and to evaluate the median progression-free interval and overall survival after the completion of treatment.
Materials and Methods
In total, 17 patients with residual or recurrent cervical cancer were enrolled in this trial. They were given a standard dose of chemotherapy according to their body surface area, i.e. topotecan 0.75 mg/m2 intravenously on day 1, 2 and 3, and cisplatin 50 mg/m2 intravenously on day 1. Treatments were repeated every 21 days for 6 cycles or until disease progression or unacceptable toxicities and then followed up 3 months for 1 year. OS and PFS rates were estimated by means of the Kaplan–Meier method. Toxicities analysis was also done.
Topotecan and cisplatin combined chemotherapy was well tolerated by all the patients with grade 2 neutropenia, leukopenia and thrombocytopenia occurring in 5.8%, anaemia in 53% and mild nausea in 11.8%. There were complete remission in 2 patients (11.8%) and partial remission in another 3 patients (17.6%) at the end of study with overall response of 29.4%. There were 3 patients (17.6%) with stable disease. The median OS was 10 months, and the median PFS was 4 months.
Topotecan and cisplatin combination was found to be effective, safe and well tolerated in patients with persistent or recurrent cervical cancer.
KeywordsTopotecan Cisplatin Residual or recurrent cervical cancer Palliative chemotherapy
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 1.GLOBOCAN 2012 (IARC), Section of cancer surveillance.Google Scholar
- 4.Globocan 2008. Cancer Incidence and Mortality Worldwide. https://www.iarc.fr/en/media-centre/iarcnews/2010/globocan2008.php.
- 6.Alfen GC, Kristensen GB, Skovlund E, et al. Histological subtypes has minor importance for overall survival in patients with adenocarcinoma of the uterine cervix; a population based study of prognostic factors in 505 patients with non-squamous cell carcinomas of cervix. Cancer. 2001;92:2471–83.CrossRefGoogle Scholar
- 8.Howlander N, Noone AM, Krapcho M, Miller D, Bishop K, Kosary CL, YU M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA, editors. SEER Cancer Statistics Review, 1975–2014, National Cancer Institute. Bethesda, MD; 2017. https://seer.cancer.gov/csr/1975_2014/.
- 10.Recurrent cervical cancer. Cancer Treatment Centres of America.Google Scholar
- 11.Delgado G, Bundu B, Ziano R, et al. Prospective surgical-pathological study of disease free interval in patients with stage IB squamous cell carcinoma of the cervix: a gynecologic oncology group study. Gynecoloncol. 1990;38:352–7.Google Scholar
- 16.Recurrent cervical cancer CTCA. https://www.cancercenter.com/cervical-cancer/stages/tab/recurrent/.
- 21.Molpus KL, Redlin-Frazier S, Reed G, et al. Postoperative pelvic irradiation in early stage uterine mixed mulleriantumors. Eur J Gynecol Oncol. 1998;19:541–6.Google Scholar