Neoadjuvant chemotherapy followed by radical surgery as an alternative treatment to concurrent chemoradiotherapy for young premenopausal patients with FIGO stage IIB squamous cervical carcinoma

Tumor Biology ◽  
2015 ◽  
Vol 36 (6) ◽  
pp. 4349-4356 ◽  
Author(s):  
ShanShan Yang ◽  
Ying Gao ◽  
Jing Sun ◽  
Bairong Xia ◽  
TianBo Liu ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Cervical Carcinoma ◽  
Alternative Treatment ◽  
Concurrent Chemoradiotherapy ◽  
Radical Surgery ◽  
Figo Stage ◽  
Premenopausal Patients ◽  
Squamous Cervical Carcinoma

Neoadjuvant chemotherapy followed by radical surgery versus concurrent chemoradiotherapy in patients with FIGO stage IIB cervical cancer: the CSEM 006 study

2020 ◽  
Vol 31 (1) ◽  
pp. 129-133
Author(s):  
Hua Tu ◽  
He Huang ◽  
Yi Ouyang ◽  
Qing Liu ◽  
Bingna Xian ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Sample Size ◽  
Primary Endpoint ◽  
Concurrent Chemoradiotherapy ◽  
Radical Surgery ◽  
Disease Free Survival ◽  
Squamous Carcinoma ◽  
Figo Stage ◽  
Paraaortic Lymphadenectomy

BackgroundConcurrent chemoradiotherapy is the first-line treatment for FIGO stage IIB cervical cancer. Neoadjuvant chemotherapy followed by radical surgery may provide another treatment option.Primary objectiveTo compare the therapeutic outcomes of neoadjuvant chemotherapy followed by surgery with cisplatin-based concurrent chemoradiotherapy for stage IIB cervical cancer.Study hypothesisWe hypothesize that the therapeutic effect of neoadjuvant chemotherapy combined with surgery and risk-adapted adjuvant treatment will be superior to that of concurrent chemoradiotherapy in stage IIB cervical cancer.Trial designPatients with stage IIB cervical cancer will be randomized 1:1 to neoadjuvant chemotherapy followed by surgery (Arm A) or concurrent chemoradiotherapy (Arm B). In arm A, patients will receive three cycles of paclitaxel and cisplatin followed by a type C radical hysterectomy and pelvic ±paraaortic lymphadenectomy. Patients showing progression after neoadjuvant chemotherapy will be referred to concurrent chemoradiotherapy. Adjuvant therapy will be recommended according to the presence of pathological risks. In Arm B, all patients will receive definitive concurrent chemoradiotherapy, including external beam pelvic radiotherapy combined with concurrent weekly cisplatin followed by brachytherapy.Major inclusion/exclusion criteriaPatients between 18 and 60 years with histologically confirmed, untreated stage IIB cervical squamous carcinoma, adenocarcinoma, or adeno-squamous carcinoma.Primary endpointThe primary endpoint is 2-year disease-free survival.Sample sizeAn estimated sample size of 240 is required to fulfill the study objectives.Estimated dates for completing accrual and presenting resultsAs of February 2020, 115 eligible patients from four institutions have been enrolled. Enrollment is expected to be completed by December 2022.Trial registration numberClinicalTrials. gov identifier: NCT02595554.

scholarly journals Clinical Outcome of Figo 2018 Stage Ib3/Iia2 Cervical Cancer Submitted to Neoadjuvant Chemotherapy Followed by Radical Surgery in Lack of Radiotherapy Equipment: A Retrospective Comparison with Concurrent Chemoradiotherapy

2021 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Radical Surgery ◽  
Study Groups ◽  
Figo Stage ◽  
Late Complications ◽  
Clinicopathologic Characteristics ◽  
Significant Difference ◽  
Characteristics Analysis

Purpose: To compare the clinical outcomes between concurrent chemoradiotherapy (CCRT) and neoadjuvant chemotherapy followed by radical surgery ((NACT-RS) among patients with cervical cancer stage IB3 and IIA2. Methods: The study retrospectively reviewed patients with (2018 FIGO) stage IB3 and IIA2 cervical cancer. The patients received either preoperative neoadjuvant chemotherapy, followed by NACT-RS or CCRT. The outcome measures were the 5-year survival and complication rate between the two groups. Results: The median follow-up was 75 months. In total, 218 patients had stage IIA2, 136 patients had stage IB3, 201 patients received CCRT, and 153 patients received preoperative NACT-RS. In the CCRT group, the incidence of early complications (Myelosuppression, gastrointestinal and urinary) was higher compared with that in the NACT-RS group (76.1 vs. 26.1%, p <0.001; respectively). However, there was no significant difference between the two study groups concerning late complications. Five-year PFS was 79.9% and 85.5% in the NACT-RS and CCRT groups, respectively (p = 0.093). Five-year OS was 86.9% and 85.5% in the NACT-RS and CCRT groups, respectively (p = 0.97). In the multivariate clinicopathologic characteristics analysis for OS, initial tumor size >4.3 cm (HR, 5.11; p<0.001), AC/ASC (HR, 1.89; p = 0.02), histologic grade 2-3 (HR, 2.25; p = 0.04), and 2018 FIGO stage IIA2 (HR, 8.67; p<0.001) were independent risk factors. Conclusions: The survival of patients with stage IB3 and IIA2 cervical cancer treated with NACT-RS was similar to that of patients treated with CCRT without increasing side effects.

Effects of Neoadjuvant Chemotherapy Plus Radical Surgery as Front Line Treatment Strategy in Patients Affected by FIGO Stage III Cervical Cancer

2016 ◽  
Vol 23 (S5) ◽  
pp. 841-849 ◽  
Author(s):  
Violante Di Donato ◽  
Michele Carlo Schiavi ◽  
Ilary Ruscito ◽  
Virginia Sibilla Visentin ◽  
Innocenza Palaia ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Treatment Strategy ◽  
Radical Surgery ◽  
Figo Stage ◽  
Stage Iii ◽  
Line Treatment ◽  
Front Line

scholarly journals Effect of neoadjuvant chemotherapy followed by radical surgery for FIGO stage IB2/IIA2 cervical cancer

Medicine ◽  
2019 ◽  
Vol 98 (21) ◽  
pp. e15604 ◽  
Author(s):  
Hui Zhao ◽  
Yue He ◽  
Li-Rong Zhu ◽  
Jian-Liu Wang ◽  
Hong-Yan Guo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Radical Surgery ◽  
Figo Stage

Anemia before and during concurrent chemoradiotherapy in patients with cervical carcinoma: Effect on progression-free survival

2003 ◽  
Vol 13 (5) ◽  
pp. 633-639 ◽  
Author(s):  
A. Obermair ◽  
R. Cheuk ◽  
K. Horwood ◽  
M. Neudorfer ◽  
M. Janda ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Concurrent Chemoradiotherapy ◽  
Progression Free Survival ◽  
Figo Stage ◽  
Tumor Stage ◽  
Free Survival ◽  
Parametrial Involvement ◽  
The Impact ◽  
Relevant Factors

To determine the impact of anemia before and during chemoradiation in patients with cervical cancer, we collected data on hemoglobin (Hb) levels before and during treatment from 60 unselected patients with cervical carcinoma. All patients had FIGO stage IB to IVA disease and were treated with concurrent chemoradiation for the aim of cure. Patients with an Hb value below or equal to the lower 25th quartile were considered anemic. Progression-free survival (PFS) was evaluated by univariate and multivariate analyses. After a median follow-up of 26.3 months, 20 patients developed disease progression. The lowest Hb during chemoradiation (nadir Hb), the stage of disease, and parametrial involvement were correlated significantly with PFS. On multivariate analysis, the nadir Hb (relative risk [RR] 0.29) and tumor stage (RR 3.4) remained the only prognostically relevant factors predicting PFS. At 60 months the PFS was 39.1% for anemic patients and 48.0% for nonanemic patients (P < 0.0002). In patients undergoing chemoradiation for cervical carcinoma, a low nadir Hb is highly predictive of shortened PFS, whereas the Hb before treatment is prognostically not significant.

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