A Comparative Analysis of Carboplatin- and Cisplatin-Based Concurrent Chemoradiation for Treating Locally Advanced Cervical Cancer: A Single-Center Observational Study

Background: For locally advanced cervical cancer (LACC), cisplatin-based chemoradiotherapy (CIS + RT) is the recommended treatment; however, its toxicity profile often limits clinical application. Thus, this study evaluated treatment outcomes and toxicity of carboplatin-based chemoradiotherapy (CARBO + RT) vs. CIS + RT. Methods: This single-center observational study included patients with LACC (Federation Internationale de Gynecologie et d'Obstetrique stages IIA-IVA) treated with weekly CARBO (area under curve 2, calculated using the Calvert formula) or CIS (40 mg/m² intravenous weekly) concurrently with standard two-dimensional external beam radiotherapy (45 Gy in 25 fractions) with subsequent intracavitary brachytherapy (7 Gy per fraction for three insertions). A total of 146 patients were analyzed (CARBO + RT: n = 72 and CIS + RT: n = 74). Primary outcome measures were tumor response rate, overall survival (OS), and two-year progression-free survival (PFS). The secondary outcome measure was acute adverse events (AEs). Results: CARBO + RT and CIS + RT groups had comparable complete response (58.3% (n = 42) vs. 64.8% (n = 48); p = 0.692); however, treatment completion was significantly higher with CARBO + RT (94.4% (n = 68)) vs. CIS + RT (81.1% (n = 60); p = 0.014). CARBO + RT group had a higher hazard of OS (hazard ratio (HR): 1.06; 95% CI: 0.41-2.75; p = 0.901) and PFS (HR: 1.47; 95% CI: 0.70-3.072; p = 0.305), though the groups did not differ significantly. CARBO + RT was associated with significantly less vomiting (p = 0.005), while grade II-IV hematologic and nonhematologic AEs were comparable (p > 0.05). Conclusion: CARBO + RT achieved oncologic outcomes comparable to CIS + RT, with superior treatment completion rates and favorable gastrointestinal tolerability. CARBO + RT represents a viable alternative, particularly in settings where CIS toxicity or hydration requirements pose clinical challenges.