Propensity Score Matched Study of Tri-Weekly vs. Weekly Platinum-Based Chemotherapy Concurrent with Radiotherapy in the Treatment of Locally Advanced Cervical Cancer

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Kullathorn Thephamongkhol
Arb-aroon Lertkhachonsuk
Chomporn Sitathanee
Petch Alisanant
Napapat Amornwichet
Chonlakiet Khorprasert
Jidapa Bridhikitti
Pornpim Korpraphong
Kobkun Muangsomboon
Sith Phongkitkarun
Saowanee Srirattanapong
Duangkamon Prapruttam
Thaworn Dendumrongsup
Kewalee Sasiwimonphan
Chamnan Tanprasertkul
Mantana Dhanachai
Jayanton Patumanond
Jiraporn Setakornnukul

Abstract

Objective: To compare tumor control and toxicity between tri-weekly chemotherapy and weekly platinum-based chemotherapy in locally advanced cervical cancer using the propensity score matching method.
Material and Methods: DESIGN: Retrospective cohort with propensity score matched population. SETTING: Four university hospitals. PARTICIPANTS: 781 advanced local cervical cancer patients. INTERVENTION: tri-weekly platinum-based chemoradiotherapy versus weekly chemoradiotherapy OUTCOMES: Overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), and toxicity, including hematological and renal toxicity.
Results: Overall median follow-up time was 59.5 months. After the propensity score matching process was completed, 326 patients were analyzed (163 in each group). The five-year OS was 66% and 64% (p 0.630); five-year LRFS was 85% and 81% (p 0.209); five-year RRFS was 89% and 94% (p 0.307); and five-year DMFS was 75% and 79% (p 0.420) in the tri-weekly and weekly groups, respectively. The patients in the tri-weekly and the weekly group had grade 2-3 neutropenia (10.5% vs 2.5%). The other toxicities appeared to be similar in both groups in terms of white blood count, platelet and creatinine.
Conclusion: There was a potential small benefit of local control (4%) and overall survival (2%) with the tri-weekly regimen but we could not demonstrate statistical significance. However, this came at the price of an increase of 7% to 8% in grade 2-3 neutropenia.

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Thephamongkhol, K. ., Lertkhachonsuk, A.- aroon ., Sitathanee, C. ., Alisanant, P. ., Amornwichet, N. ., Khorprasert, C. ., Bridhikitti, J. ., Korpraphong, P. ., Muangsomboon, K. ., Phongkitkarun, S. ., Srirattanapong, S. ., Prapruttam, D. ., Dendumrongsup, T. ., Sasiwimonphan, K. ., Tanprasertkul, C. ., Dhanachai, M. ., Patumanond, J. ., & Setakornnukul, J. . (2022). Propensity Score Matched Study of Tri-Weekly vs. Weekly Platinum-Based Chemotherapy Concurrent with Radiotherapy in the Treatment of Locally Advanced Cervical Cancer. Siriraj Medical Journal, 74(4), 245–255. https://doi.org/10.33192/Smj.2022.31
Section
Original Article

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