Neoadjuvant Chemotherapy Followed by Radical Surgery in Treatment of Locally Advanced Cervical Carcinoma

Fatma MF Akl, Mohamed Farouk Akl, Basel Refky, Khaled Gaballah and Basma Gadelhak

Department of Clinical Oncology & Nuclear Medicine, Mansoura University, Egypt
Department of Surgical Oncology Unit, Mansoura University, Egypt
Department of Radio-Diagnosis, Mansoura University, Egypt

^*Correspondance to: Fatma MF Akl 

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Abstract:

Background &
Objective: Cervical cancer is the second cause of cancer death in women with about 70% of patients identified at an advanced stage. Currently, platinum based concurrent chemo radiotherapy is the standard of care for locally advanced cervical carcinoma., poor prognosis and survival were reported in patients with tumors larger than 4 cm in diameter, to improve these results, a new treatment modality with Neoadjuvant Chemotherapy (NAC) followed by radical surgery or chemoradiotherapy has been evolved. This study was conducted to assess the efficacy of neoadjuvant chemotherapy in down staging and achieving operability in locally advanced cervical carcinoma.Patients &
Methods: Thirty seven female patients with pathologically proven locally advanced cervical carcinoma stage (IIB up to IIIB) were included into this prospective study. All patients received neoadjuvant chemotherapy consisted ofcisplatin 75 mg/m2 (or carboplatin AUC 5) and paclitaxel 175 mg/m2 on day 1 for a maximum of 3 cycles. Assessment of operability was done 2 weeks after the third cycle by MRI and examination under anesthesia. Surgically candidate patients were referred for radical hysterectomy.Results: Among the 37 patients treated with neoadjuvant chemotherapy, 29 patients (78.4%) achieved response (CR+PR). Complete response was detected in 7 (18.9%) patients, 22 (59.5%) patients expressed partial response, 8 (21.6%) patients had stable disease; no progressive disease was detected in any of the patients, of the 29 patients who achieved response, 20 (69%) patients (54.1% of the total 37 patients) became resectable & underwent surgery.Conclusion: In conclusion, neoadjuvant chemotherapy is an efficient and tolerable treatment option in down staging of locally advanced cervical cancer also, it represents plus radical surgery a preliminary local control for locally advanced stages, especially if access to radiation oncology centers is limited with long waiting lists.

Keywords:

Cervical carcinoma; Neoadjuvant chemotherapy; Cisplatin; Paclitaxel; Radical surgery

Cite the Article:

Fatma MF Akl, Mohamed Farouk Akl, Refky B, Gaballah K, Gadelhak B. Neoadjuvant Chemotherapy Followed by Radical Surgery in Treatment of Locally Advanced Cervical Carcinoma. Clin Oncol. 2018; 3: 1523.