A Retrospective Comparison of Weekly Paclitaxel Plus Carboplatin and Cisplatin-Based Concurrent Chemoradiotherapy in Advanced Cervical Cancer

Background : We compared the efficacy and safety of concurrent chemoradiotherapy using weekly paclitaxel plus carboplatin versus cisplatin in patients with advanced cervical cancer. Methods : We retrospectively examined patients with FIGO stage IB2–IVB cervical cancer who received concurrent chemoradiotherapy with paclitaxel plus carboplatin or cisplatin between January 2009 and December 2024. Progression-free survival and overall survival were evaluated using the Kaplan–Meier method and compared using log-rank tests. Multivariate Cox proportional hazards models were used to identify prognostic factors. Results : Overall, 183 patients were included (paclitaxel plus carboplatin, 155; cisplatin, 28). Patients in the cisplatin group were significantly older. Tumor diameter was larger and the rate of intracavitary brachytherapy use was lower in the paclitaxel plus carboplatin group. In the paclitaxel plus carboplatin and cisplatin groups, 5-year progression-free survival rates were 64.9% and 61.5%, respectively (P = 0.500); the 5-year overall survival rates were 70.5% and 69.2%, respectively (P = 0.981). Multivariate analysis identified age ≥65 years, tumor diameter ≥6 cm, and use of intracavitary brachytherapy as independent prognostic factors for overall survival; treatment regimen was not significantly associated with survival. Grade ≥3 neutropenia was more frequent in the paclitaxel plus carboplatin group; renal toxicity was significantly more frequent in the cisplatin group. No significant differences with respect to late adverse events were observed. Conclusion : Paclitaxel plus carboplatin concurrent chemoradiotherapy demonstrated efficacy comparable to cisplatin concurrent chemoradiotherapy in patients with advanced cervical cancer. Paclitaxel plus carboplatin concurrent chemoradiotherapy may be a safe and feasible alternative, particularly for older patients or those with impaired renal function.