Carboplatin versus cisplatin: an observational study in locally advanced cervical cancer

Background : Cisplatin-based chemoradiation is the standard treatment for locally advanced cervical cancer. However, the toxicity and prolonged infusion time associated with cisplatin urges the search for options that yield similar outcomes. Our objective is to compare the effectiveness of carboplatin versus cisplatin. Methods : The current study is observational and retrospective, consisting of 183 patients with locally advanced cervical cancer who underwent chemoradiation treatment at the National Institute of Neoplastic Diseases, Lima, Peru, between 2014 and 2015. We analyzed their adverse events, response to therapy, disease evolution, and survival outcomes. Results : The squamous cell carcinoma subtype represented 89.6% of the sample, and the most frequent stages were IIB (64%) and IIIC (27%). The trend for complete responses was higher for cisplatin (82%) than carboplatin (77%) but not statistically significant (p=0.3). Neutropenia, diarrhea, and vomiting were the most reported events, with the former being significantly lower in the carboplatin group (p=0.001). At a 5-year follow-up, there was a 41% reduction in the risk of progression and a 28% reduction in risk of death in favor of cisplatin treatment (PFS: HR 0.59, 95% CI 0.34-1.00, p=0.055 and OS: HR 0.72, 95% CI 0.33-1.57, p=0.4). Generally, it was observed that those who achieved a complete response had better survival (p<0.001). Conclusions : In summary, while there are no differences in efficacy, carboplatin is slightly better tolerated. This suggests that carboplatin could be a valid alternative for patients with a more delicate clinical condition who might face challenges with cisplatin-associated toxicity.