Comparative Study of Neoadjuvant Chemotherapy Followed by Definitive Chemoradiotherapy Versus Definitive Chemoradiotherapy Alone in Locally Advanced Carcinoma of Cervix
Carcinoma in the cervix is the most common malignancy and the fourth most common cause of death in females worldwide. It is the most common malignancy in India, the increasing incidence of cancer is escalating burden over radiation. This is a prospective randomized study comparing NACT followed by definitive chemoradiation versus chemoradiation.
Materials and Methods
This prospective randomized study analyzed 80 cervical cancer patients who were treated at our center during March 2017 and July 2018. Patients were divided into two arms: one received NACT and definitive CT/T and the other received definitive CT/RT. Statistical analysis was done using SPSS V.20 software.
Overall response rate in our study was found to be 96.2%. In the study group, it was 97.5%, whereas in the control group, it was 95%. Majority of patients were in the age group 41–50 years, mainly stage IIb and IIIb. Tumor response in both the arms was similar and statistically significant (Chi2 = 0.348; p > 0.05). The hematologic toxicities ( p > 0.05) were more in the NACT group than in the CCRT group, while gastrointestinal toxicities were slightly higher in the control (statistically insignificant).
NACT with taxane/platin followed by definitive CT/RT is as effective as the standard care in the treatment of locally advanced cervical cancer. It has even shown better results (p value > .005) and is also helpful in reducing systemic micrometastasis and bulk of the disease. It can be used as an alternative to the standard care at the places of long waiting time for the definitive treatment, without compromising the outcome.
KeywordsCancer cervix Neo adjuvant chemotherapy Locally advanced cancer cervix Indian setup cancer management Paclitaxel Carboplatin
Locally advanced cancer cervix
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
The author and coauthors declare that this is an original article and has none of the following ethical issues. The manuscript has not been submitted to more than one journal for simultaneous consideration. The manuscript has not been published previously (partly or in full), unless the new work concerns an expansion of previous work. A single study is not split up into several parts to increase the quantity of submissions and submitted to various journals or to one journal over time (e.g., “salami-publishing”). No data have been fabricated or manipulated (including images) to support our conclusions. No data, text, or theories by others are presented as if they were the author’s own (“plagiarism”). Consent to submit has been received explicitly from all coauthors, as well as from the responsible authorities—tacitly or explicitly—at the institute/organization where the work has been carried out, before the work is submitted. Authors have contributed sufficiently to the scientific work and therefore share collective responsibility and accountability for the results.
- 1.Vishwanathan A, Halperin EC, Wazer DE, et al. Principles and practice of radiation oncology. In: Halperin EC, editor. Perez and Brady’s Principles and practice of radiation oncology. 6th ed. Philadelphia: Wolters Kluwer Health; 1934.Google Scholar
- 2.Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int J Gynecol Obstet. 2009;145:129–35.Google Scholar
- 3.Human Papillomavirus (HPV) Vaccines: Q & A. Fact sheets: risk factors and possible causes. National Cancer Institute (NCI). 2009. pp. 10–22. Retrieved 2009-11-11.Google Scholar
- 4.Bruni L, Barrionuevo-Rosas L, Albero G, et al. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in [Botswana]. Summary Report. 2014.Google Scholar
- 8.Woo YJ, Byun JM, Jeong D. Prognosis of stage IIb cervical cancer among treatment regimens: radical hysterectomy versus neoadjuvant chemotherapy followed by radical hysterectomy versus concurrent chemoradiotherapy. KJOG. 2012;55:913–9.Google Scholar
- 11.Rath GK, Mohanti BK, editors. Textbook of radiation oncology: principles and practice. New Delhi: BI Churchill Livingstone, 2000 (ISBN 81-7042-166-7); Elsevier, 2003 (Reprint).Google Scholar