Pros and Cons of Adding of Neoadjuvant Chemotherapy to Standard Concurrent Chemoradiotherapy in Cervical Cancer: A Regional Cancer Center Experience

Narayan, Satya; Sharma, Neeraj; Kapoor, Akhil; Sharma, Rajani; Kumar, Narendra; Mukesh, Srivastava; Purohit, Ramesh; Jakhar, Shankar Lal; Beniwal, Surender; Kumar, Harvindra Singh; Sharma, Aruna

doi:10.1007/s13224-015-0698-5

Cited by 17 publications

(16 citation statements)

References 9 publications

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“…In the present study, NACT did not bring advantages in OS and PFS. Harsh et al [17] showed that the 3- and 5-year OS and disease-free survival (DFS) in 332 patients who received NACT combined with concurrent chemoradiotherapy were significantly longer than in those who received concurrent chemoradiotherapy alone, as supported by Marita et al [18] Narayan et al [19] analyzed 612 patients with locally advanced cervical carcinoma, and compared NACT combined with concurrent chemoradiotherapy vs chemotherapy alone, and similar results were obtained. For these patients, it is possible that giving NACT and then performing sequential concurrent chemoradiotherapy may achieve better clinical outcomes.…”

Section: Discussionmentioning

confidence: 80%

Neoadjuvant chemotherapy does not improve the prognosis and lymph node metastasis rate of locally advanced cervical squamous cell carcinoma

Yan¹,

Ding³

et al. 2019

Medicine

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Locally advanced cervical carcinoma has a poor prognosis. Neoadjuvant chemotherapy (NACT) can reduce tumor size and improve tumor resection rate, but its use in large locally advanced cervical carcinoma is controversial. This study aimed to evaluate the treatment and prognosis of NACT in patients with cervical carcinoma stage IB2 or IIA2.This was a retrospective cohort study of patients who underwent type-C radical surgery and pelvic lymphadenectomy due to cervical carcinoma stage IB2/IIA2 between 2/2014 and 12/2016 at the Second Hospital of Jilin University. The patients were grouped according to whether they received NACT (paclitaxel and a platinum salt) or not. Overall survival (OS) and progression-free survival (PFS) were compared between the 2 groups.Of the 144 patients, 60 (41.7%) received NACT. A total of 119 patients underwent postoperative radiation therapy, of which 97 received radiation therapy alone and 22 received concurrent chemoradiotherapy. The adverse reactions in the NACT group were mainly hematologic toxic reactions, but were tolerated. No grade ≥III adverse reactions were observed. NACT did not significantly affect the PFS (P = .453) and OS (P = .933) between the 2 groups. No factor was found to be independently associated with OS or PFS (all P > .05).Compared with patients who underwent surgery with/without radiotherapy and/or chemotherapy, NACT using paclitaxel and a platinum salt does not improve the prognosis and lymph node metastasis rate of locally advanced cervical carcinoma in Chinese patients.

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Section: Discussionmentioning

confidence: 80%

Neoadjuvant chemotherapy does not improve the prognosis and lymph node metastasis rate of locally advanced cervical squamous cell carcinoma

Yan¹,

Ding³

et al. 2019

Medicine

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“…Cervical cancer represents the third leading cause of cancer death in females in the developing countries 2. India accounts for nearly one-third of cervical cancer deaths worldwide, with ~132,000 new cases and 74,000 deaths reported each year 3. The current screening methods to detect cervical cancer include cytological-based Pap smears and human papillomavirus (HPV) lesions detected through HPV testing 4.…”

Section: Introductionmentioning

confidence: 99%

<em>Hedychium coronarium</em> extract arrests cell cycle progression, induces apoptosis, and impairs migration and invasion in HeLa cervical cancer cells

Ray

Jena²,

Dash³

et al. 2019

CMAR

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BackgroundHedychium coronarium Koen. (Zingiberaceae) is traditionally used as medicine in countries such as India, China, and Vietnam for treatment of various ailments including cancer. However, in spite of its implied significance in cancer treatment regimes, there are no reports so far involving the anticancerous attributes of H, coronarium ethanol extract (HCEE) on cancer cells and a more comprehensive study on its mechanism is still lacking.Materials and methodsThe cytotoxicity of HCEE was evaluated by MTT and clonogenic survival assay. Annexin V/propidium iodide (PI), Hoechst 33342 staining, and TUNEL assay were performed to detect apoptosis. Cell cycle analysis was performed using PI staining. JC-1 and 2′,7′-dichlorodihydrofluorescein diacetate assay were used to check the levels of MMP and ROS, respectively. Western blot analysis was carried out to measure the expression levels of proteins. Migration and invasion activity were assessed by wound healing and Transwell membrane assay, respectively.ResultsAntiproliferative effect of HCEE was investigated in various cancerous and normal cell lines. Among these, HCEE significantly inhibited the survival of HeLa cells without affecting the viability of normal human umbilical vein endothelial cells. Annexin V/PI, Hoechst staining, and TUNEL assay showed HCEE induced apoptosis in HeLa cells in a dose-dependent manner. HCEE promoted cell cycle arrest at G1 phase in HeLa cells by upregulating the levels of p53 and p21 and downregulating the levels of cyclin D1, CDK-4, and CDK-6. Moreover, HCEE treatment upregulated the expression of Bax and downregulated the expression of Bcl-2. Additionally, HCEE activated the caspase cascade by increasing the activities of caspase-9, caspase-8, and caspase-3. The expression levels of Fas ligand and Fas were also upregulated. Further, HCEE inhibited the migratory potential of HeLa cells by downregulating MMP-2 and MMP-9 expression levels.ConclusionOur results indicate H. coronarium exerts antiproliferative and apoptotic effects against HeLa cells, and therefore may be used for treatment against cervical cancer.

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“…Evidence supporting the use of NACT prior to RT/CCRT is limited, with most data comprising retrospective case studies from India [19][20][21], or small phase II trials [5,[22][23][24] that often had short follow up periods and reported response rate rather than survival. Until very recently, there was no randomised evidence available.…”

Section: Results In the Context Of Published Literaturementioning

confidence: 99%

Neoadjuvant chemotherapy in locally advanced cervical cancer: real-world data from the Cancer Medicines Outcomes Programme (CMOP)

Baillie¹,

Reed²,

Laskey³

et al. 2021

EJGO

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To report the outcomes of neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer, we conducted a retrospective study of 126 patients. Methods: The electronic chemotherapy prescribing system was used to identify patients from the West of Scotland Cancer Network who received NACT over a 5 year period. Baseline characteristic and treatments details were collected. Association of treatment type and other variables with overall survival (OS) were analysed using Cox proportional hazards model. Results: The median follow up was 30 months. Median age was 44 years (interquartile range 34-54), 86% had squamous pathology and 93% had at least International Federation of Gynaecology & Obstetrics (FIGO) stage II disease at diagnosis. 27% had stage IV disease and 30% had para-aortic nodal involvement. NACT regimens consisted primarily of 3 weekly cisplatin/paclitaxel (63%) or carboplatin/paclitaxel (35%). 86% of patients subsequently received chemoradiotherapy (CCRT), 11% radical radiotherapy alone and the remaining patients progressed or defaulted. Three year OS was 61.8% (95% CI (Confidence Interval) 53.4-71.6). Survival was poorer in patients with neutrophil lymphocyte ratio (NLR) ≥5 (hazard ratio 2.8 (95% CI 1.32-5.90)) and in those not receiving CCRT (hazard ratio 2.23 (95% CI 1.01-4.91)). Conclusions: Three year OS was reasonable considering the advanced nature of the cohort and suggests that NACT is an option for women with bulky cervical cancer.

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Pros and Cons of Adding of Neoadjuvant Chemotherapy to Standard Concurrent Chemoradiotherapy in Cervical Cancer: A Regional Cancer Center Experience

Cited by 17 publications

References 9 publications

Neoadjuvant chemotherapy does not improve the prognosis and lymph node metastasis rate of locally advanced cervical squamous cell carcinoma

Neoadjuvant chemotherapy does not improve the prognosis and lymph node metastasis rate of locally advanced cervical squamous cell carcinoma

<em>Hedychium coronarium</em> extract arrests cell cycle progression, induces apoptosis, and impairs migration and invasion in HeLa cervical cancer cells

Neoadjuvant chemotherapy in locally advanced cervical cancer: real-world data from the Cancer Medicines Outcomes Programme (CMOP)

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Pros and Cons of Adding of Neoadjuvant Chemotherapy to Standard Concurrent Chemoradiotherapy in Cervical Cancer: A Regional Cancer Center Experience

Cited by 17 publications

References 9 publications

Neoadjuvant chemotherapy does not improve the prognosis and lymph node metastasis rate of locally advanced cervical squamous cell carcinoma

Neoadjuvant chemotherapy does not improve the prognosis and lymph node metastasis rate of locally advanced cervical squamous cell carcinoma

<em>Hedychium coronarium</em>&nbsp;extract arrests cell cycle progression, induces apoptosis, and impairs migration and invasion in HeLa cervical cancer cells

Neoadjuvant chemotherapy in locally advanced cervical cancer: real-world data from the Cancer Medicines Outcomes Programme (CMOP)

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<em>Hedychium coronarium</em> extract arrests cell cycle progression, induces apoptosis, and impairs migration and invasion in HeLa cervical cancer cells