Neoadjuvant chemotherapy with weekly cisplatin and paclitaxel followed by chemoradiation for locally advanced cervical cancer
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Authors
Li, Jing
Li, Ya
Wang, Huafeng
Shen, Lifei
Wang, Qun
Shao, Siqi
Shen, Yuhong
Xu, Haoping
Liu, Hua
Cai, Rong
Issue Date
2023-01-14
Type
Article
Language
en_US
Keywords
Dose-Dense , Neoadjuvant Chemotherapy (NACT) , Weekly Cisplatin/Paclitaxel , Concurrent Chemoradiation (CCRT) , Locally Advanced Cervical Cancer (LACC)
Alternative Title
Abstract
Background:
Currently, the standard treatment for locally advanced cervical cancer is concurrent chemoradiation (CCRT). Forty percent of patients present with disease recurrence. This study aims to investigate the feasibility, safety and efficacy of neoadjuvant chemotherapy (NACT) with weekly cisplatin and paclitaxel (TP) followed by CCRT.
Methods:
We are conducting a phase III trial comparing the efficacy and side effects of patients with cervical cancer (FIGO 2018 stage IIB to IVA) who were assigned to four cycles of NACT with cisplatin (40 mg/m2) and paclitaxel (60 mg/m2) weekly followed by CCRT or CCRT alone. In this report, we studied the medium-term effect of 50 patients enrolled in the NACT + CCRT arm. The primary endpoints were the response rate post-NACT and 12 weeks post-CCRT evaluated by MR/CT based on RECIST v 1.1. The secondary endpoints were 3-year OS (overall survival) and PFS (progression-free survival) measured by the Kaplan–Meier method.
Results:
Among 50 patients enrolled in the NACT + CCRT arm, the complete and partial response rates were 10.4% and 68.8%, post-NACT. Twelve weeks after treatment completion, the complete response rate was 72.0%, whereas the total response rate (complete and partial response) was 90.0%. After a median follow-up of 28 months, the 3-year OS rate was 83.9%, and the 3-year PFS rate was 73.6%. NACT response was related to superior PFS and OS compared with NACT nonresponse (P < 0.01). Late AEs were exiguous, while early AEs mainly included myelosuppression and gastrointestinal AEs.
Conclusions:
This study showed a good response rate achieved by dose-dense weekly cisplatin and paclitaxel followed by standard CCRT. The treatment regimen is feasible, as evidenced by the acceptable toxicity of NACT and by the high compliance with radiotherapy.
Description
Citation
Li, J., Li, Y., Wang, H., Shen, L., Wang, Q., Shao, S., Shen, Y., Xu, H., Liu, H., Cai, R., & Feng, W. (2023). Neoadjuvant chemotherapy with weekly cisplatin and paclitaxel followed by chemoradiation for locally advanced cervical cancer. BMC cancer, 23(1), 51. https://doi.org/10.1186/s12885-023-10517-x
Publisher
BMC Cancer