TREATMENT OUTCOME AND TOXICITY OF NEOADJUVANT CHEMOTHERAPY FOLLOWED BY CONCOMITANT CHEMORADIOTHERAPY VERSUS CONCOMITANT CHEMORADIATION ALONE IN LOCALLY ADVANCED CERVICAL CARCINOMA: A COMPARATIVE STUDY

Abstract

Objectives: This study intended to explore the outcome, and toxicities of neoadjuvant chemotherapy in addition to standard treatment concomitant chemoradiation in locally advanced cervix cancer. Methods: Sixty-two (n=62) locally advanced cervical carcinoma patients were randomized into two arms: The controlled arm (30 patients) received concomitant chemoradiation with external beam radiation therapy of 50 Gy to the whole pelvis and Inj. Cisplatin (40 mg/m2/week) alone and the study arm (32 patients) received three cycles, neoadjuvant chemotherapy with Inj. Paclitaxel (175 mg/m2), and Inj. Cisplatin (75 mg/m2) at 3 weekly intervals, followed by concomitant chemoradiation with external beam radiation therapy (EBRT) of 50 Gy to whole pelvis and Inj. Cisplatin (40 mg/m2/week). Responses to treatment, toxicities, disease-free survival, and progression-free survival (PFS) were analyzed in both arms. Results: Among the total of 62 patients, 30 were in the concomitant chemoradiation alone arm and 32 were in neoadjuvant chemotherapy followed by the concomitant chemoradiation arm. The median follow-up period was about 13 months. The tumor response in the form of complete or partial responses was equivalent in the two arms. The disease-free survival and the PFS were also comparable in both arms. The acute and the late toxicities were also comparable in the two arms. Conclusions: This study showed that neoadjuvant chemotherapy with paclitaxel and cisplatin before definitive concomitant cisplatin-based chemoradiation can be used as an alternative in the management of locally advanced carcinoma of the cervix.