Introduction/Background Cervical cancer is the most common reproductive cancer in women of childbearing age. The radiation therapy and surgical treatment are currently considered a cornerstone of locally-advanced cervical cancer treatment. For several decades a number of different treatment options aimed to improve the survival of cervical cancer patients. One of these methods studied is the use of neoadjuvant chemotherapy. This study aims to evaluate the clinical outcomes and toxicity of platinum-containing dose-intensive neoadjuvant chemotherapy regimens in patients with locally-advanced FIGO IB2 - IIB cervical cancer.
Methodology A cohort of 105 consecutive patients with median age of 44 (range 27–68) years was studied. All patients had verified locally-advanced (cT1B2Nx,0M0 - cT2BNxM0) cervical cancer and received 3 dose-intensive intravenous neoadjuvant AP (cisplatin 75 mg/m2, doxorubicin 35 mg/m2; n=75) or TP (cisplatin 60 mg/m2 and paclitaxel 60 mg/m2; n=30) chemotherapy cycles. The effectiveness of neoadjuvant treatment was determined using magnetic resonance imaging of the pelvic organs (according to the criteria RECIST 1.1.), the operability rate, the pathological response. The toxicity was evaluated according to CTCAE 4.03 criteria.
Results The objective response rate was 84% (63/75 cases) for AP and 56.7% (17/30 cases) for TP group, accordingly. Also in 66 (88%) patients of AP and 24 (80%) of TP group the surgical intervention was performed. The pathomorphological response rate 89,4% (59/66 cases) for AP and 79,2% (19/24 cases) for TP group. The complete morphological tumor regression (ypCR) was confirmed in 7 (10,6%) cases for AP, and 4 (16,7%) cases for TP group. Both dose-intensive regimens were characterized by moderate toxicity, no severe adverse effects during chemotherapy or surgical treatment stages were observed.
Conclusion The dose-intensive chemotherapy is an effective treatment modality for locally-advanced cervical cancer and may be a feasible alternative for standard treatment approach. It deserves further study in larger patient cohort with evaluation of the long-term results.
Disclosure Nothing to disclose.
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