Progression of Disease with Neo-Adjuvant Chemotherapy in Locally Advanced Cervical Cancer: Case Reports and Literature Review

Abstract

Background: Optimal treatment for locally advanced cervical cancer is still a controversial issue as the current standard therapy is associated with radiation toxicity. Neo-adjuvant chemotherapy followed by surgery is an alternative treatment modality which has promising outcomes. Cases: Two cases of cervical carcinoma, aged 33 and 40 years old, stage 1b2 and 1b3, given neoadjuvant chemotherapy (NACT) with combination of platinum-based agents and Taxane, and planned for radical surgery after completion of chemotherapy. Result: Progression of disease observed in both cases after 3rd cycle of chemotherapy required change of treatment modalities to standard chemoradiation therapy (CCRT). Conclusion: NACT followed by surgery has promising outcomes as it gives advantages in lower long-term complication, targeted in younger-aged group and sexually active women for better quality of life, besides offering similar survival rates compared with CCRT. Estimation of response rate to chemotherapy plays a major role in patient selection in order to have successful outcomes.