Clinical Analysis of Combination Chemotherapy with Paclitaxel Plus Carboplatin and 5-Fu Plus Carboplatin for Advanced Penile Carcinoma in HIV-positive Patients

Objective To compare the clinical efficacy and toxicity of paclitaxel versus 5-fluorouracil (5-Fu) combined with carboplatin for the treatment in patients with advanced penile carcinoma associated with AIDS. Methods Fifty-eight patients were enrolled in this study,these patients with advanced penile carcinoma and infected by HIV which were confirmed by serologic biopsy and cytology evidence.Thirty patients in the paclitaxel and carboplatin group(TC group) administered paclitaxel at a dose of 175 mg/m2 given intravenously on day one,carboplatin at a dose of AUC=5 given intravenously on day one every 21 days cycle.Twenty-eight patients in 5-Fu and carboplatin group(FC group) administered 5-Fu at a dose of 1 000 mg/m2 given intravenously on four consecutive days,carboplatin at a dose of AUC=5 given intravenously on day one every 21 days cycle. Results All the 58 patients were assessable for response.The objective overall response rate was 56.7% in paclitaxel and carboplatin group and 17.9% in 5-Fu and carboplatin group,respectively(χ²=9.265，P=0.002).The median time to disease progression was 11.15 months vs.7.22 months (χ²=6.737，P=0.009).The median duration of response was 17.36 months vs.9.11 months (χ²=10.646，P=0.001).The most common toxicity was myelosuppression,nausea,vomit.The rates of grade Ⅲ~Ⅳ leucopenia were 46.4% and 40.0% (χ²=0.222，P=0.637).The rates of grade Ⅲ~Ⅴ nausea and vomit were 36.0% and 34.78% (χ²=0.008，P=0.930). Conclusion sCombination chemotherapy with paclitaxel and carboplatin is an effective and safe regimen in the treatment for patients with advanced penile carcinoma associated with AIDS.