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Platinum-free Interval in Second-line Chemotherapy for Recurrent Cervical Cancer

Matoda, Maki MD; Tanigawa, Terumi MD; Omatsu, Kohei MD; Ushioda, Norichika MD; Yamamoto, Akiko MD; Okamoto, Sanshiro MD; Kawamata, Yasutaka MD; Kato, Kazuyoshi MD; Umayahara, Kenji MD; Takeshima, Nobuhiro MD

International Journal of Gynecological Cancer: November 2013 - Volume 23 - Issue 9 - p 1670–1674
doi: 10.1097/IGC.0b013e3182a80a07
Cervical Cancer

Objective The purpose of this study was to determine whether the platinum-free interval (PFI) was a predictive indicator in second-line treatment of cervical cancer in patients who had undergone prior platinum-based chemotherapy. The role of the PFI in selecting the second-line regimen in other gynecologic malignancies is also discussed.

Methods In this retrospective study, we examined the clinical records of patients with recurrent or metastatic cervical cancer who had received platinum-containing combination regimens as second-line chemotherapy. All patients had received prior platinum-containing chemotherapy or concurrent chemoradiotherapy.

Results The overall response rate to second-line chemotherapy was 25.8%; 7 patients achieved a complete response and 17 a partial response. The median progression-free survival (PFS) was 5.1 months and median overall survival (OS) was 13.5 months. The response rate was 12.5%, 14.2%, 20.0%, 22.2%, and 55.0%; median PFS was 4.0, 5.1, 4.4, 5.8, and 7.4 months; and median OS was 10.2, 14.4, 11.9, 16.3, and 19.7 months when PFI was within 3, 3 to 5, 6 to 11, 12 to 23, and more than 24 months, respectively. Age (>50 years), size (>3 cm), prior radiotherapy, and PFI (>24 months) were identified as prognostic factors in the multivariate analysis for PFS and OS.

Conclusions The results indicate that a PFI of more than 24 months is the discriminating point between platinum-sensitive and platinum-resistance cervical cancer. This indicates that PFI offers a useful tool in selecting agents for second-line chemotherapy in a wide range of gynecologic malignancies.

Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan.

Address correspondence and reprint requests to Maki Matoda, MD, Department of Gynecology, Cancer Institute Hospital, Ariake 3-8-31, Koutou-ku, Tokyo, 135-8550, Japan. E-mail:

The authors declare no conflicts of interest.

Received June 11, 2013

Accepted August 4, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.