Neoadjuvant Chemotherapy with Weekly Cisplatin and Paclitaxel Followed by Chemoradiation for Locally Advanced Cervical Cancer

Description

Abstract (English)

Abstract 
Introduction: Locally advanced cervical cancer (LACC) remains a significant therapeutic challenge, with 
standard treatment involving concurrent chemoradiation. Neoadjuvant chemotherapy (NACT) before 
chemoradiation may improve tumor shrinkage, facilitate better local control, and reduce distant metastasis. This 
study evaluates the efficacy and safety of weekly cisplatin and paclitaxel as neoadjuvant chemotherapy followed 
by chemoradiation in patients with LACC. 
Methods: This prospective observational study was conducted over a period of one year at R G Kar Medical 
College. A total of 80 patients with histologically confirmed locally advanced cervical cancer (FIGO stages IB2 
to IIIB) were enrolled. Key study variables included patient age, FIGO stage, tumor histology, and Eastern 
Cooperative Oncology Group (ECOG) performance status. Patients received neoadjuvant chemotherapy with 
weekly cisplatin and paclitaxel followed by chemoradiation. Treatment response was assessed using clinical and 
radiological parameters, while toxicity was monitored and graded according to standard criteria. Outcomes 
measured included tumor response, toxicity profile, progression-free survival, and overall survival. 
Results: The study included 80 patients with locally advanced cervical cancer, predominantly FIGO stage IIB 
and squamous cell carcinoma. Following neoadjuvant chemotherapy with weekly cisplatin and paclitaxel, 85% 
of patients achieved an overall response (30% complete, 55% partial). Tumor size significantly decreased from 
5.4 cm to 3.2 cm (p < 0.001). The treatment was well tolerated, with manageable hematological and non
hematological toxicities. At 12 months follow-up, progression-free survival was 72.5%, and overall survival was 
85%. Patients with complete or partial response had significantly better survival outcomes than those with stable 
or progressive disease (PFS: 14 vs. 8 months, p = 0.002; OS: 18 vs. 11 months, p = 0.004). 
Conclusions: Weekly cisplatin and paclitaxel as neoadjuvant chemotherapy followed by standard chemoradiation 
is feasible and well tolerated in LACC patients, with encouraging early clinical response and survival outcomes. 
Further randomized controlled trials are warranted to confirm the benefit of this sequential approach compared to 
chemoradiation alone.