Cancer Research and Treatment

Original Articles

Phase II Study of Consolidation Chemotherapy after Adjuvant or Primary Concurrent Chemoradiation Using Paclitaxel and Carboplatin to Treat High-Risk Early-Stage or Locally Advanced Cervical Cancer: Hee Seung Kim, Mi-Kyung Kim, Hak Jae Kim, Seung-Su Han, Jae Weon Kim; Cancer Res Treat. 2012;44(2):97-103. Published online June 30, 2012; DOI: https://doi.org/10.4143/crt.2012.44.2.97

PURPOSE
This study investigated the efficacy and toxicity associated with consolidation chemotherapy using paclitaxel and carboplatin after concurrent chemoradiation (CCR) in cervical cancer patients.
MATERIALS AND METHODS
From a total of 37 patients, 19 with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA cervical cancer (group 1) underwent surgery followed by consolidation chemotherapy after CCR, and 18 with stage IIB-IVA disease (group 2) received consolidation chemotherapy after primary CCR. Three cycles of chemotherapy using paclitaxel (135 mg/m2) and carboplatin (AUC 5.0) were administered every 3 weeks for CCR therapy, and three cycles of consolidation chemotherapy using paclitaxel (175 mg/m2) and carboplatin (AUC 5.0) were used every 3 weeks after CCR.
RESULTS
The complete and partial response rates were 77.8% and 22.2% in group 2. Moreover, the 3-year progression-free and overall survival rates were 62.7% and 90.9% in group 1, and 51.9% and 60% in group 2, respectively. The most common grade 3 or 4 hematologic toxicities observed were leukopenia (group 1, 10.5%; group 2, 13.0%) and neutropenia (group 1, 7.0%; group 2, 14.8%), and grade 3 or 4 diarrhea (group 1, 1.8%) and febrile illness (group 2, 1.9%) were the most frequently observed non-hematologic toxicities. When we compared these results with previous reports, consolidation chemotherapy after CCR using paclitaxel and carboplatin revealed a relatively lower complete response rate (77.8% vs. 87-100%, respectively) and shorter progression-free survival (51.9-62.7% vs. 81-86%, respectively) and overall survival (60-90.9% vs. 81-95%, respectively) in spite of similar toxicity findings.
CONCLUSION
Due to low efficacy results, consolidation chemotherapy using paclitaxel and carboplatin after CCR is not a feasible treatment regimen for high-risk early-stage or locally advanced cervical cancer.

Citations

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Radiomics feature is a risk factor for locally advanced cervical cancer treated using concurrent chemoradiotherapy based on magnetic resonance imaging: a retrospective study
Yuan Wang, Yanyan Yu, Lina Gu, Yunfeng Sun, Jiazhuo Yan, Hongxia Zhang, Yunyan Zhang
BMC Cancer.2025;[Epub] CrossRef
Efficacy and safety of consolidation chemotherapy after adjuvant therapy in stage IB-IIA cervical cancer patients with risk factors: a retrospective single-center study
Jiaxin Wang, Huaijuan Guo, Jingjing Yang, Jingxian Mao, Ying Wang, Ruidong Gao, Xuebing Yan, Jie Wang
Frontiers in Oncology.2024;[Epub] CrossRef
The effectiveness of consolidation chemotherapy in high-risk early-stage cervical cancer patients following concurrent chemoradiation after radical surgery
Cong Wang, Chunli Fu, Changdong Ma, Qiuhong Qian, Fangfang He, Guangyu Zhang
Japanese Journal of Clinical Oncology.2023; 53(2): 122. CrossRef
Efficacy and safety of adjuvant chemotherapy for locally advanced cervical cancer: A systematic review and meta-analysis
Xiao Ma, Jin Fang, Lu Zhang, Yao Huang, Hui Shen, Xiaohua Ma, Shuixing Zhang, Bin Zhang
Critical Reviews in Oncology/Hematology.2023; 184: 103953. CrossRef
The effect of consolidation chemotherapy after concurrent chemoradiation on the prognosis of locally advanced cervical cancer: a systematic review and meta-analysis
Lan Zhong, Kemin Li, Liang Song, Rutie Yin
Journal of Obstetrics and Gynaecology.2022; 42(5): 830. CrossRef
Role of Adjuvant Chemotherapy After Concurrent Chemoradiotherapy in Patients With Locally Advanced Cervical Cancer
Lingna Kou, Tao Zhang, Xiling Yang, Siyun Peng, Yifei Wang, Mingyang Yuan, Minmin Li
Future Oncology.2022; 18(16): 1917. CrossRef
Integration of Consolidation Chemotherapy After Concurrent Chemoradiation in the Treatment of Locally Advanced Uterine Cervical Cancer
V. S. Haritha, Laxmi Singotia, Rajesh Jain, A. K. Saxena, Shyamji Rawat, Lalit Patel
Indian Journal of Gynecologic Oncology.2022;[Epub] CrossRef
A Multi-Institutional Retrospective Analysis of Oncologic Outcomes for Patients With Locally Advanced Cervical Cancer Undergoing Platinum-Based Adjuvant Chemotherapy After Concurrent Chemoradiotherapy
Ning Wu, Xing Su, Honglin Song, Ying Li, Fei Gu, Xiaoge Sun, Xiaofan Li, Guanghui Cheng
Cancer Control.2021;[Epub] CrossRef
Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis
Nanda Horeweg, Prachi Mittal, Patrycja L. Gradowska, Ingrid Boere, Supriya Chopra, Remi A. Nout
Cancers.2021; 13(8): 1880. CrossRef
How should we stage and tailor treatment strategy in locally advanced cervical cancer? Imaging versus para-aortic surgical staging
Alejandra Martinez, Martina Aida Angeles, Denis Querleu, Gwenael Ferron, Christophe Pomel
International Journal of Gynecological Cancer.2020; 30(9): 1434. CrossRef
Clinical Analysis of Apatinib in the Treatment of Patients with Residual Tumor after Radical Chemoradiotherapy for Locally Advanced Cervical Cancer
Jun Jiang, Wei Hong Wei, Tao Xu
Journal of Cancer Research Updates.2020; 9(1): 20. CrossRef
Chemoradiotherapy followed by consolidation chemotherapy involving paclitaxel and carboplatin and in FIGO stage IIIB/IVA cervical cancer patients
Seiji Mabuchi, Fumiaki Isohashi, Mika Okazawa, Fuminori Kitada, Shintaro Maruoka, Kazuhiko Ogawa, Tadashi Kimura
Journal of Gynecologic Oncology.2017;[Epub] CrossRef
Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer
Kyungmi Yang, Won Park, Seung Jae Huh, Duk-Soo Bae, Byoung-Gie Kim, Jeong-Won Lee
Radiation Oncology Journal.2017; 35(1): 39. CrossRef
Substantieller Vorteil durch CT-geplante HDR-Brachytherapie bei Zervixkarzinompatientinnen im Vergleich zu historischen Serien bezüglich lokaler Kontrolle und Toxizität?
Simone Marnitz
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Simone Marnitz-Schulze
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Prognostic Value of Log Odds of Positive Lymph Nodes after Radical Surgery Followed by Adjuvant Treatment in High-Risk Cervical Cancer
Jeanny Kwon, Keun-Yong Eom, In Ah Kim, Jae-Sung Kim, Young-Beom Kim, Jae Hong No, Kidong Kim
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A phase II study of postoperative concurrent carboplatin and paclitaxel combined with intensity-modulated pelvic radiotherapy followed by consolidation chemotherapy in surgically treated cervical cancer patients with positive pelvic lymph nodes
Seiji Mabuchi, Fumiaki Isohashi, Takeshi Yokoi, Masahiko Takemura, Kiyoshi Yoshino, Yasuhiko Shiki, Kimihiko Ito, Takayuki Enomoto, Kazuhiko Ogawa, Tadashi Kimura
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Correlations Between Radiation Dose in Bone Marrow and Hematological Toxicity in Patients With Cervical Cancer
Yu Chang, Zhi-Yong Yang, Gui-Ling Li, Qin Li, Qin Yang, Ji-Quan Fan, Ying-Chao Zhao, Ying-Qiu Song, Gang Wu
International Journal of Gynecological Cancer.2016; 26(4): 770. CrossRef
Randomized phase III trial of radiotherapy or chemoradiotherapy with topotecan and cisplatin in intermediate-risk cervical cancer patients after radical hysterectomy
Wenze Sun, Tao Wang, Fan Shi, Jiquan Wang, Juan Wang, Beina Hui, Yingbing Zhang, Jinli Lu, Hongwei Chen, Zi Liu
BMC Cancer.2015;[Epub] CrossRef
Time-window of early detection of response to concurrent chemoradiation in cervical cancer by using diffusion-weighted MR imaging: a pilot study
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Adjuvant chemotherapy after concurrent chemoradiation for locally advanced cervical cancer
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Comparison of Clinical Efficacy of Three Different Neoadjuvant Approaches (Chemotherapy Combined Vaginal Intracavitary Irradiation, Neoadjuvant Chemotherapy Alone or Radiotherapy) Combined with Surgery for Patients with Stage Ib2 and IIa2 Cervical Cancer
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Asian Pacific Journal of Cancer Prevention.2013; 14(4): 2377. CrossRef
A Phase I Study of Concurrent Weekly Carboplatin and Paclitaxel Combined With Intensity-Modulated Pelvic Radiotherapy as an Adjuvant Treatment for Early-Stage Cervical Cancer Patients With Positive Pelvic Lymph Nodes
Seiji Mabuchi, Ryoko Takahashi, Fumiaki Isohashi, Takeshi Yokoi, Kimihiko Ito, Tateki Tsutui, Toshiyuki Ogata, Yasuo Yoshioka, Kazuhiko Ogawa, Tadashi Kimura
International Journal of Gynecological Cancer.2013; 23(7): 1279. CrossRef

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High-Dose Chemotherapy of Cyclophosphamide, Thiotepa and Carboplatin (CTCb) followed by Autologous Stem-Cell Transplantation as a Consolidation for Breast Cancer Patients with 10 or more Positive Lymph Nodes: a 5-Year follow-Up Results: Hee-Jung Sohn, Sang-Hee Kim, Gyeong-Won Lee, Shin Kim, Jin-Hee Ahn, Sung-Bae Kim, Sang-We Kim, Woo Kun Kim, Cheolwon Suh; Cancer Res Treat. 2005;37(3):137-142. Published online June 30, 2005; DOI: https://doi.org/10.4143/crt.2005.37.3.137

Abstract PDF PubReader ePub

Purpose

The benefit of consolidation high-dose chemotherapy (HDC) for high-risk primary breast cancer is controversial. We evaluated the efficacy and safety of consolidation HDC with cyclophosphamide, thiotepa and carboplatin (CTCb) followed by autologous stem-cell transplantation (ASCT) in resected breast cancer patients with 10 or more positive lymph nodes.

Materials and Methods

Between December 1994 and April 2000, 22 patients were enrolled. All patients received 2 to 6 cycles of adjuvant chemotherapy after surgery for breast cancer. The HDC regimen consisted of cyclophosphamide 1,500 mg/m²/day, thiotepa 125 mg/m²/day and carboplatin 200 mg/m²/day intravenous for 4 consecutive days.

Results

With a median follow-up of 58 months, 11 patients recurred and died. The median disease-free survival (DFS) and median overall survival (OS) were 49 and 69 months, respectively. The 5-year DFS and OS rates were 50% and 58%, respectively. The 12 patients with 10 to 18 involved nodes had better 5-year DFS (67%) and OS (75%) than 10 patients with more than 18 involved nodes (30% and 38%, respectively). The most common grade 3 or 4 nonhematologic toxicity was diarrhea, which occurred in 5 patients (23%). No treatment-related death was observed.

Conclusion

Consolidation HDC with CTCb followed by ASCT for resected breast cancer with more than 10 positive nodes had an acceptable toxicity but does not show promising survival.

Citations

Citations to this article as recorded by

Real-world Experience of Improvement in the Survival of Lymphoma and Myeloma Patients with Autologous Stem Cell Transplantation over a 25-year Period
Hyungwoo Cho, Shin Kim, Kyoungmin Lee, Jung Sun Park, Cheolwon Suh
The Korean Journal of Medicine.2021; 96(6): 501. CrossRef
Prospective study of cyclophosphamide, thiotepa, carboplatin combined with adoptive DC-CIK followed by metronomic cyclophosphamide therapy as salvage treatment for triple negative metastatic breast cancers patients (aged <45)
X. Wang, J. Ren, J. Zhang, Y. Yan, N. Jiang, J. Yu, L. Di, G. Song, L. Che, J. Jia, X. Zhou, H. Yang, H. K. Lyerly
Clinical and Translational Oncology.2016; 18(1): 82. CrossRef

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Hematologic malignancy

Cyclophosphamide, Bortezomib, and Dexamethasone Consolidation in Patients with Multiple Myeloma after Stem Cell Transplantation: The KMM130 Study: Jongheon Jung, Kihyun Kim, Sung-Hoon Jung, Sung-Soo Yoon, Jae Hoon Lee, Jin Seok Kim, Ho-Jin Shin, Soo-Mee Bang, Sang Kyun Sohn, Cheolwon Suh, Dok Hyun Yoon, Sun-Young Kong, Chang-Ki Min, Hyeon-Seok Eom, The Korean Multiple Myeloma Working Party; Cancer Res Treat. 2023;55(2):693-703.; DOI: https://doi.org/10.4143/crt.2022.952

Abstract PDF Supplementary Material PubReader ePub

Purpose
A three-drug combination of cyclophosphamide, bortezomib, and dexamethasone (CVD) shows significant efficacy and manageable toxicity as induction therapy in patients with multiple myeloma.
Materials and Methods
In this phase II study, we enrolled 45 patients who achieved a very good partial response (VGPR) or partial response (PR) after autologous stem cell transplantation (ASCT) and evaluated the efficacy and toxicity of CVD consolidation. CVD consolidation comprised three cycles of cyclophosphamide 300 mg/m² orally on days 1, 8, and 15, and bortezomib 1.3 mg/m² subcutaneously on days 1, 8, 15, and 22, along with dexamethasone 20 mg orally or intravenously on days 1 and 2, 8 and 9, 15 and 16, and 22 and 23.
Results
At enrollment, 39 patients (86.7%) showed VGPR, and nine (13.3%) presented with PR. Nineteen patients (45.2%) achieved a complete response or better as their best response after the end of consolidation. Overall, 22 of 42 patients (52.4%) experienced an improved response status with CVD consolidation. Three-year overall survival and progression-free survival rates were 89.0% and 42.7%, respectively. The most common non-hematologic toxicities were peripheral neuropathy and infection (20.5%), with no grade ≥ 3 neuropathy observed.
Conclusion
These results showed that CVD consolidation therapy improved the response with reasonable toxicity in patients with residual disease after ASCT. This trial was registered with the Clinical Research Information Service, Republic of Korea (KCT0001327).

Citations

Citations to this article as recorded by

Is There Still a Role for Stem Cell Transplantation in Multiple Myeloma?
Morie A. Gertz
Hematology/Oncology Clinics of North America.2024; 38(2): 407. CrossRef
Ginsenoside Rg1 inhibits multiple myeloma and overcomes bortezomib resistance through AMPK-mTOR pathway
Li Lin, Dong Chen, Shuangyue Li, Tiantian Wang
Heliyon.2024; 10(13): e33935. CrossRef

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Prognostic Implications of Cytarabine Dose in Consolidation Chemotherapy for the Patients with Acute Myelogenous Leukemia: Jung Hee Lee, Je Hwan Lee, Kyoo Hyung Lee, Hyeseung Bahng, Jin Hee Ahn, Jung Shin Lee, Sang Hee Kim, Woo Kun Kim; J Korean Cancer Assoc. 2000;32(5):954-961.

Abstract PDF: PURPOSE
Increasing the dose of cytarabine in consolidation chemotherapy has been suggested to improve treatment outcome of the patients with acute myelogenous leukemia (AML) in complete remission (CR). We studied an effect of cytarabine dose in consolidation chemotherapy on the survival times.
MATERIALS AND METHODS
From 1989 to 1998, AML patients in CR who received two or more courses of consolidation chemotherapy were included. At the first course of consolidation chemo therapy, all patients received standard dose of cytarabine (100 or 200 mg/m2/day by a continuous infusion for 5 days) plus anthracyclines. At the second or third course, one of three dose levels of cytarabine was given with anthracyclines. Three dose levels of cytarabine were standard dose (SD), intermediate dose (ID, 1 or 2 g/m2/day by a 3-hour infusion for 5 days), and high dose (HD, 3 g/m2 in a 3-hour infusion every 12 hours for total six doses). We retrospectively reviewed clinical records of study patients.
RESULTS
64 patients were included. The median follow-up duration of alive patients was 1,143 days. Estimated 3-year overall survival times were 24% in SD group, 41% in ID group and 56% in HD group (P=0.737). Estimated 3-year disease free survival times were 18%, 16% and 44% in each group (P=0.592). There was no significant difference in toxicity of consolidation chemotherapy between three groups.
CONCLUSION
Although the survival times showed a trend to be longer in the patients who received higher dose of cytarabine as consolidation chemotherapy, there were no statistically significant differences.

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Autologous or Allogeneic Bone Marrow Transplantation Compared with Consolidation Chemotherapy in Acute promyelocytic Leukemia: Chang Ki Min, Woo Sung Min, Hee Je Kim, Hyun Suk Eom, Jong Wook Lee, Kyungja Han, Ihl Bhong Choi, Chun Choo Kim, Won IL Kim, Dong Jip Kim; J Korean Cancer Assoc. 1999;31(2):331-338.

Abstract PDF: PURPOSE
Acute promyelocytic leukemia (APL) is a distinct subtype of acute myelogenous leukemia characterized by the morphology of blast cells (M3 in FAB classification), the t (15;17) translocation, and a coagulopathy combining disseminated intravascular coagulation and fibrinolysis. It has been considered to have better response to combination chemo- therapy of an anthracycline and cytosine arabinoside and a higher cure rate than other subtypes because of recent approach of differentiating leukemic blasts by all-transretinoic acid (ATRA). The role of stem cell transplantation in APL has to be determined in comparison with that of consolidation chemotherapy.
MATERIALS AND METHODS
We compared the leukemia-free survival and overall survival between APL patients receiving the consolidation chemotherapy and those undergoing the allogeneic or autologous stem cell transplantation following the high-dose anticancer therapy. Of the 65 patients achieving the first complete remission from 1992 to 1997, 33 patients were treated with 3 courses of consolidation chemotherapies and 32 with the stem cell transplantation.
RESULTS
With a median follow-up of 22 months (8-60), the actuarial leukemia-free survival at 3 years was significantly higher in transplantation group than in chematherapy group (73.8% versus 33.5%; P=0.0087), and the probability of leukemic relapse was considerably lower in transplantation group than in chemotherapy group (6.3% versus 57.5%; P=0.001). The treatment-related mortalities of the groups were 0% in chemotherapy group and 14.3% in transplantation group. The main cause of deaths was relapse in the consolidation chemotherapy group.
CONCLUSION
These data demonstrate that the stem cell transplantation results in better leukemia-free survival than the consolidation chemotherapy for patients with APL in the first complete remission because of lower risk of relapse.

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