Treatment of early bulky cervical cancer with neoadjuvant paclitaxel, carboplatin and cisplatin prior to laparoscopical radical hysterectomy and pelvic lymphadenectomy

Abstract

Abstract. The objective of this study was to evaluate the efficacy and safety of neoadjuvant chemotherapy (NAC) with paclitaxel combined with carboplatin and cisplatin prior to laparoscopic radical hysterectomy and pelvic lymphadenectomy. A total of 19 patients who had bulky cervical cancer of International Federation of Gynecology and Obstetrics (FIGO) Stage Ib2 to IIb2 (lesion diameter >4 cm) received NAC with paclitaxel combined with carboplatin and cisplatin prior to laparoscopic radical hysterectomy and pelvic lymphadenectomy. The tumor diameter, the response rate, the resection rate and the lymph node metastasis rate after chemotherapy, as well as the toxicity were evaluated. All patients successfully received NAC, with the exception of 1 patient with FIGO Stage Ib2 and 7 cm tumor diameter, who rejected complete therapy. The tumor diameter was reduced from 4.93±0.81cm before NAC to 2.57±1.90 cm after treatment (P<0.01), and the overall response rate [complete remission (CR) + partial remission (PR)] was 78.9% (15/19). Two patients received radiotherapy after NAC, 1 patient was found to have cystic metastasis during the surgery and the operative rate was 83.3% (15/18). Pelvic lymph node metastasis was found in 2 of the 18 patients (11.1%) without parametrial and vaginal margin involvement. Hematological toxicity was the most common side effect and the 3-4 toxicity level was only 11.1% (2/18). In conclusion, NAC with paclitaxel, combined with carboplatin and cisplatin, followed by laparoscopic radical hysterectomy and pelvic lymphadenectomy was found to be effective and safe. Thus, NAC is the ideal treatment for patients with early bulky cervical cancer.

Relationships between Histopathology Type and Neoadjuvant Chemotherapy Response for Cervical Cancer Stage IB2 and IIA2

“…There were several reasons to use neoadjuvant chemotherapy to shrink the tumor size for facilitating surgery, reduce the rate of recurrence, and increase survival. However, in patients who were resistant to chemotherapy, it would delay the provision of definitive therapy, so important to find a marker to identify which patients were more resistant to chemotherapy relatively [8], [9]. cancer in patients with stage IB2 and IIA2 cervical cancer before neoadjuvant chemotherapy treatment and conducted from May 2018 until March 2019 at the Dr. M. Djamil Hospital Padang.…”

Knockdown of ST6Gal-I increases cisplatin sensitivity in cervical cancer cells

“…In addition, most cases occur at 40-54 years of age, which could lead to enormous social devastation [3]. The traditional treatment of cervical cancer is surgery or radiation therapy [4]. Despite significant improvements in surgical techniques and radiotherapy for the treatment of cervical cancer, its overall survival rate remains low.…”

The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review

“…The survival rates were not reported in 4 studies. 11 , 16 , 20 , 40 These 4 trials evaluated the treatment response as an objective treatment effect and did not include survival data. Additionally, 5 more trials 18 , 26 , 31 , 35 , 39 were excluded from the survival analysis, because they included postoperative radiotherapy in the treatment protocol.…”