Comparison of Neoadjuvant Chemotherapy Followed by Radical Hysterectomy and Neoadjuvant Chemoradiation Followed by Radical Hysterectomy with Concurrent Chemoradiation in Locally Advanced Carcinoma Cervix (FIGO Stages IB2, IIA2, IIB): Interim Results of a Randomized Control Study

Abstract

Objectives:To investigate the therapeutic efficacy, toxicity profile and quality of life in locally advanced cervical carcinoma treated with concurrent chemoradiation therapy (CCRT), preoperative chemoradiation (PCRT) and preoperative chemotherapy (PCHEMO) followed by surgical implications Materials and methods: A total of (N = 100) locally advanced cervical cancer patients (FIGO stages IB2, IIA2 and IIB) was treated between June 2014 to March 2018, Out of 100 patients, 33 patients treated with CCRT arm (50Gy EBRT and 21Gy brachytherapy), 33 patients treated with PCRT arm (50Gy EBRT) followed by radical hysterectomy, 34 patients with PCHEMO arm followed with radical hysterectomy using 3 weekly cisplatin (75 mg/m 2 and paclitaxel (175 mg/m 2 ). Patient's Quality life was recorded with a standard questionnaire. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 22. Results:The median follow-up period was found to be 28 months. However less statistical significance was obtained between various parameters such as age, FIGO stage, performance status, perioperative morbidities, and symptoms scales among three arms (p > 0.05). 97%, 94%, 88% of overall response rates noted in CCRT, PCRT and PCHEMO arm patients respectively. But 55% and 24% of PCRT and PCHEMO arm patients had pathological complete responses with the significance of p = 0.0016. CCRT arm patients had a larger amount of symptom expertise, difficulties in sexual functioning and sexual agony. Conclusion:We observed equivalent therapeutic response, better toxicity profile and better quality of life among the patients treated with PCRT arm than the standard CCRT arm patients. Clinical significance:This approach could be feasible in developing countries wherein brachytherapy resources are scarce.

Retrospective Analysis on the Need for Surgery for Residual Disease after Chemoradiation in Carcinoma Cervix

“…5 The standard of care for LACC is definitive chemoradiation which consists of platin-based chemotherapy regimen along with radiation therapy (intensity-modulated radiotherapy), followed by intracavitary brachytherapy. 6 In 2018, FIGO included lymph nodes in their staging system either by MRI or histopathological examination. 7 Concurrent chemoradiation in LACC improves the local control of the disease.…”