Treatment complication, pathologic response and survival rate after chemotherapy before surgery in locally advanced cervical cancer

Hosseini, Sareh and Hasanzadeh Mofrad, Malihe and Aghel, Elahe and Homaei Shandiz, Fatemeh and Yousofi, Zohre and Shahid Sales, Soodabeh and Farazestanian, Marjaneh and Joudi, Mona (2020) Treatment complication, pathologic response and survival rate after chemotherapy before surgery in locally advanced cervical cancer. The Iranian Journal of Obstetrics, Gynecology and Infertility, 22 (12). pp. 1-10.

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Introduction: Cervical cancer is the second most common cancer in less developed countries. Chemoradiation is the standard treatment for advanced cervical cancer, but there is a lack of radiotherapy equipment in developing country. Therefore, this study was performed with aim to evaluate the pathologic response, treatment complication and survival rate of patients with locally advanced squamous cell carcinoma (SCC) of cervix who were not candidate for chemoradiation with use of chemotherapy before surgery. Methods: In this single group, before-after randomized clinical trial, 24 patients with FIGO stages IB2, IIA2, and IIB squamous cell carcinoma (SCC), who were not candidate for standard chemoradiation due to different causes, received 3 courses of neoadjuvant paclitaxel (135mg/m2)+ Cisplatin (75mg/m2) chemotherapy regimen. Then, surgery was performed. Clinical response to neoadjuvant chemotherapy and treatment side effects were assessed after each course. Wertheim hysterectomy was done 4 to 6 weeks later in those with favorable response. In the absence of major risk factors in the surgical pathology, patients received 3 additional cycles of adjuvant chemotherapy. In high risk patients, adjuvant chemoradiotherapy was performed. Data was analyzed by SPSS software (version 21) and Chi-square, and Kaplan Mayer tests. PResults: Among 24 patients, 13 cases (54.2) and 17 (73.9) had FIGO stageIIB and gradeII tumors, respectively. Parametrial involvement was presented in 13 patients (54.2). Seven patients were excluded. 17 patients underwent surgical resection. Four high risk patients and were candidate for chemoradiation. Clinical and complete pathological response rate were 17 cases (70.8) and 8 cases (47.1), respectively. With a median follow up of 18.5 months, mean of overall survival and disease free survival of patients treated with the study protocol were 24.51 and 25.71 month, respectively. The mean of overall survival of whole patients (24 cases) was 30.8 month (CI: 95, 29/38-32/26). Conclusion: Neoadjuvant chemotherapy in patients with locally advanced cervical cancer despite acceptable pathologic response is not associated with survival advantage.

Item Type: Article
Uncontrolled Keywords: Cervical Cancer,neoadjuvant treatment,Survival analysis
Subjects: WP Gynecology
WQ Obstetrics
Divisions: Journals > Iranian J Obstetrics, Gynecology and Infertility
Depositing User: ijogi ijogi
Date Deposited: 30 Apr 2020 11:47
Last Modified: 30 Apr 2020 11:47

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