The Efficacy and Safety of Neoadjuvant Chemotherapy in Treatment of Locally Advanced Carcinoma Cervix

Singh, Uaday; Ahirwar, Neetu; Rani, Anju; Singh, Nisha; Sankhwar, Pushplata; Qureshi, Sabuhi

doi:10.1007/s13224-012-0342-6

Cited by 8 publications

(6 citation statements)

References 14 publications

(10 reference statements)

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“… 19 , 23 , 29 A recent Chinese study 30 reported a 5-year overall response rate of 67% in the RTCT arm and 53% in the RT arm. Singh et al 31 reported less morbidity and mortality with neoadjuvant CT. There have been some contradictory reports.…”

Section: Discussionmentioning

confidence: 97%

Concurrent Chemoradiation for Cancer of the Cervix: Results of a Multi-Institutional Study From the Setting of a Developing Country (India)

Nandakumar¹,

Rath²,

Kataki³

et al. 2015

JGO

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PurposeThe primary output of hospital-based cancer registries is data on cancer stage and treatment-based survival that can be used to evaluate patient care, but because there are many challenges in obtaining follow-up details, a separate study on patterns of care and patterns of survival for patients at selected sites was initiated under the National Cancer Registry Programme of India. This article presents the results for cervical cancer.Patients and MethodsA standardized patient information form was used to record patient information, and data were entered into a central repository—the National Centre for Disease Informatics and Research. The study patients were from 12 institutions and were diagnosed between January 1, 2006, and December 31, 2008. Patterns of treatment were assessed for 7,336 patients, and patterns of survival were determined for 2,669 patients from six institutions, at least 70% of whom had data regarding follow-up as of December 31, 2012.ResultsOf 7,336 patients, 55.5% received optimal radiotherapy (RT). In all, 80.9% of patients had locally advanced cancers (stage IIB to IVA), 51.1% received RT alone, and 44.4% received concurrent chemoradiation (RTCT). In 1,753 patients with locally advanced cancers, significantly better survival was observed with RTCT than with RT alone (5-year cumulative survival, 70.2% v 47.3%; hazard ratio, 0.48; 95% CI, 0.41 to 0.56).ConclusionA conservative estimate indicates that, on an annual basis, 38,771 patients with cervical cancers in India alone do not get the benefit of RTCT and thus they have poorer survival. There is a need to reiterate the National Cancer Institute's alert that advised supplementing chemotherapy to radiation for locally advanced cancer of the cervix in the context of the developing world, where 84.3% of cancers of the cervix occur.

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Section: Discussionmentioning

confidence: 97%

Concurrent Chemoradiation for Cancer of the Cervix: Results of a Multi-Institutional Study From the Setting of a Developing Country (India)

Nandakumar¹,

Rath²,

Kataki³

et al. 2015

JGO

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“…Although excellent tumor control can be achieved after CCRT, impaired quality of life due to radiation-induced ovarian failure and vaginal fibrosis is significant [4]. Furthermore, in developing countries, radiotherapy facilities are not always readily available [5]. Against this background, neoadjuvant chemotherapy (NACT) combined with radical hysterectomy has been proposed as a possible alternative to CCRT.…”

Section: Introductionmentioning

confidence: 99%

Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

et al. 2016

PLoS ONE

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BackgroundThe impact of hyperglycemia on survival of patients undergoing neoadjuvant chemotherapy (NACT) for bulky early stage cervical cancer (BESCC) has not been explored.MethodRecords of patients who received NACT and radical hysterectomy in our institution between January 2005 and June 2010 were reviewed.ResultsIn total, 347 patients were included. The median follow-up time was 37 months (range: 4–65). Patients with hyperglycemia (fasting blood glucose ≥ 100 mg/dl) had shorter recurrence-free survival (RFS) (univariate hazard ratio [HR] = 1.95, 95% confidence interval [CI] [1.16, 3.28], P = 0.010) and cancer-specific survival (CSS) (univariate HR = 2.24, 95% CI [1.33, 3.78], P = 0.002) compared with those with euglycemia (fasting blood glucose <100 mg/dl). In multivariate analysis, positive surgical margins, parametrium invasion, node metastasis, hyperglycemia and complete response to NACT independently predicted recurrence and cancer-specific death. To further validate the prognostic value of hyperglycemia, we conducted a subgroup analysis based on patient baseline characteristics and prognostic effect of hyperglycemia remained significant in all subgroups. On multivariable logistic regression analysis, euglycemia before NACT, squamous cell tumor and pre-treatment squamous cell carcinoma antigen levels < 3.5 ng/ml were identified as independent predictors of complete response after NACT.ConclusionsFBG ≥100 mg/dl is a negative prognostic predictor for cervical cancer patients receiving NACT for BESCC. Patients with hyperglycemia are less likely to achieve complete response after NACT. Our findings underscore the clinical utility of hyperglycemia screening of for cervical cancer patients.

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“…Uterine cervical squamous cell carcinoma (SCC) is the second most common cause of cancer mortality in women on a global scale . Unfortunately, some patients with advanced stages or recurrences fall into disease relapse after chemotherapy and radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

Functional significance of transgelin‐2 in uterine cervical squamous cell carcinoma

Yakabe

Murakami

Kajimura

et al. 2016

J of Obstet and Gynaecol

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The Efficacy and Safety of Neoadjuvant Chemotherapy in Treatment of Locally Advanced Carcinoma Cervix

Cited by 8 publications

References 14 publications

Concurrent Chemoradiation for Cancer of the Cervix: Results of a Multi-Institutional Study From the Setting of a Developing Country (India)

Concurrent Chemoradiation for Cancer of the Cervix: Results of a Multi-Institutional Study From the Setting of a Developing Country (India)

Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

Functional significance of transgelin‐2 in uterine cervical squamous cell carcinoma

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