Concurrent chemoradiation with carboplatin for elderly, diabetic and hypertensive patients with locally advanced cervical cancer

Introduction: Chemoradiation based on cisplatin is the standard treatment of locally advanced cervical cancer, however. a Subset of patients are either elderly and/or have comorbidities Such as diabetes and hypertension. These conditions may compromise the administration of cisplatin. We report Our Institution experience with weekly carboplatin as a radiosensitizer for the management of this Subset of patients. Patients and Methods: We reviewed the files of 59 patients with locally advanced cervical cancer who were treated with primary chemoradiation with weekly carboplatin. Response rate, toxicity and survival were analyzed. Results: Mean age was 62 years (range, 36-83 years). The majority of cases were squamous cell carcinoma (88.14%). and distribution according to FIGO Stage was IB2 8.4%, IIA 13.5%, IIB 52.5%, IIIA 33% and IIIB 18.6%; Overall, 100% and 91% of patients completed external beam and intracavitary therapy. Seventy-nine percent received from five to six planned cycles of weekly carboplatin. Complete responses were achieved in 49 (83.05%) patients, whereas ten patients (16.95%) had either persistent or progressive disease. The most common toxicities were grades I and 2 hematological and gastrointestinal. At median follow-up (20 months: range 2-48 months), 16 patients (32.65%) have relapsed. Estimated 30-month overall survival is 63%. Conclusions: Weekly carboplatin concurrent with pelvic radiation is well tolerated in patients with locally advanced carcinoma of the cervix who are older than 70 years and/or have diabetes mellitus and/or high blood pressure, however, the apparently slightly lower Survival observed cautions against its routine use.