Retrospective study of the efficacy and safety of docetaxel/carboplatin combination therapy as postoperative adjuvant chemotherapy for nonsquamous cell carcinoma of the cervix

Int J Clin Oncol. 2023 Oct;28(10):1421-1430. doi: 10.1007/s10147-023-02392-0. Epub 2023 Aug 16.

Abstract

Objective: Optimal adjuvant chemotherapy for nonsquamous cervical carcinoma has not yet been established. This study investigated the efficacy and safety of docetaxel/carboplatin (DC) for early-stage nonsquamous cell cervical carcinoma after radical hysterectomy (RH).

Methods: We evaluated 157 patients with stage IB-IIB nonsquamous cervical carcinoma with intermediate risk and high risk treated at our institution with DC after type II or III RH from 2007 to 2021. Patients received docetaxel (60-70 mg/m2) and carboplatin (area under the curve 5-6) every 3 weeks for six cycles. The primary endpoint was 2 year recurrence-free survival (RFS) and the secondary endpoint was adverse events (AEs).

Results: There were 106 intermediate-risk and 51 high-risk patients. The high-risk patients included 11 with positive parametrial involvement, 20 with pelvic lymph node metastases, and 20 with both parametrial involvement and pelvic lymph node metastases. The 2 year RFS rates for intermediate-risk, high-risk, and positive pelvic lymph nodes were 94.8% (95% confidence interval [CI], 87.9-97.8), 80.1% (95% CI, 64.1-89.5), and 74.5% (95% CI, 55.4-86.4), respectively. Sixteen patients had recurrence, including local recurrence (n = 6), distant metastasis (n = 9), and local and distant metastasis (n = 1). Hematologic toxicity was the most frequent AE, especially leukopenia and neutropenia. Nausea and constipation were the most frequent nonhematologic toxicities.

Conclusion: DC therapy at our institution showed good 2 year RFS, and postoperative adjuvant therapy with DC therapy is suggested as a useful strategy for patients with nonsquamous cervical carcinoma.

Keywords: Adjuvant chemotherapy; Cervical cancer; Nonsquamous carcinoma.

MeSH terms

  • Carboplatin
  • Carcinoma* / drug therapy
  • Cervix Uteri / pathology
  • Chemotherapy, Adjuvant
  • Docetaxel / therapeutic use
  • Female
  • Humans
  • Hysterectomy
  • Lymphatic Metastasis
  • Neoplasm Staging
  • Retrospective Studies
  • Survival Rate
  • Uterine Cervical Neoplasms* / drug therapy
  • Uterine Cervical Neoplasms* / pathology
  • Uterine Cervical Neoplasms* / surgery

Substances

  • Carboplatin
  • Docetaxel