Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
The Journal of Obstetrics and Gynecology of India
Published in: The Journal of Obstetrics and Gynecology of India 5/2016

01-10-2016 | Original Article

Induction Chemotherapy Followed by Concurrent Chemoradiation in the Management of Different Stages of Cervical Carcinoma: 5-year Retrospective Study

Authors: Kamlesh Kumar Harsh, Akhil Kapoor, Murali Paramanandhan, Satya Narayan, Ramesh Purohit, Pramila Kumari, Mukesh Kumar Singhal

Published in: The Journal of Obstetrics and Gynecology of India | Issue 5/2016

Login to get access

Abstract

Aim

The data of survival for Indian cervical cancer patients treated by indigenous modifications of the protocol are scarce. The objective of this retrospective study was to analyze the efficacy and tolerability in patients of cervical carcinoma treated by neoadjuvant chemotherapy followed by concurrent chemoradiation.

Materials and Methods

Three hundred and thirty two cases of squamous cell carcinoma of cervix who received 3 cycles of neoadjuvant chemotherapy followed concurrent chemoradiation were retrospectively analyzed for overall survival (OS), disease-free survival (DFS), and local pelvic control rate.

Results

The 3-year OS and DFS were 93.7 % for stage I-B, 88.0 and 84.0 % for stage II-A, 82.8 and 79.7 % for stage II-B, 70.0 and 64.9 % for stage III-A, 59.3 and 52.4 % for stage III-B, and 53.6 and 32.1 % for stage IV-A disease. The 5-year OS and DFS rates were 93.7 and 87.5 % for stage I-B, 84.0 % for Stage II-A, 79.7 and 76.6 % for stage II-B, 67.6 and 59.5 % for stage III-A, 48.4 and 41.9 % for stage III-B, and 28.6 and 14.3 % for stage IV-A disease.

Conclusion

Neoadjuvant chemotherapy followed by concurrent chemoradiation is feasible and produces impressive disease-free and overall survival. This protocol is especially helpful for busy cancer centers with long waiting lists on radiotherapy machines.
Literature
1.
Ferlay J, Soeryomataram I, Ervik M, et al. GLOBOCAN2012, Cancer incidence and mortality worldwide: IARC Cancer Base No. 11. Internet J Lyon France: International Agency for Research on Cancer; 2013.
2.
Bray F, Ren JS, Masuyer E, et al. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013;132(5):1133–45.CrossRefPubMed
3.
Antonio GM, Lucia GC, Natalia C, et al. The Current role of neoadjuvant chemotherapy in the management of cervical carcinoma. Gynecol Oncol. 2008; 110(3 Suppl 2): S36–40.
4.
Logsdon MD, Eifel PJ. Squamous cell carcinoma of the uterine cervix: an analysis of prognostic factors emphasizing the balance between external beam and intra-cavitary radiation therapy. Int J Radiat Oncol Biol Phys. 1999;43(4):763–75.CrossRefPubMed
5.
Perez CA, Brady LW, Halperin EC, et al. Principles and practice of radiation oncology. 6th ed. Philadelphia: LWW; 2013. p. 1390–1.
6.
Sardi J, Sananes C, Giaroli A, et al. Neoadjuvant chemotherapy in locally advanced carcinoma of the cervix uteri. Gynecol Oncol. 1990;38(3):486–93.CrossRefPubMed
7.
Huang HJ, Chang TC, Hong JH, et al. Prognostic value of age and histologic type in neo-adjuvant chemotherapy plus radical surgery for bulky (≥4 cm) stage I-B and II-A cervical carcinoma. Int J Gynecol Cancer. 2003;13(2):204–11.CrossRefPubMed
8.
Morris M, Eifel PJ, Lu J, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high risk cervical cancer. N Engl J Med. 1999;340(15):1137–43.CrossRefPubMed
9.
Symonds RP, Habeshaw T, Reed NS, et al. The Scottish and Manchester randomized trail of Neo-adjuvant chemotherapy for advanced cervical cancer. Eur J Cancer. 2000;36(8):994–1001.CrossRefPubMed
10.
Napolitano U, Imperato F, Mossa B, et al. The role of neo-adjuvant chemotherapy for squamous cell cervical cancer (Ib-IIIb: a long term randomized trial. Eur J Gynaecol Oncol. 2003;24(1):51–9.PubMed
11.
Thomas G, Dembo A, Fyles A, et al. Concurrent chemo-radiation in advanced cervical cancer. Gynaecol Oncol. 1990;38(3):446–51.CrossRef
12.
Chang TC, Lai CH, Hong JH, et al. Randomized trial of neoadjuvant cisplatin, vincristine, bleomycin, and radical hysterectomy versus radiation therapy for bulky stage IB and IIA cervical cancer. J Clin Oncol. 2000;18(8):1740–7.PubMed
13.
Rose PG, Bundy BN, Watkins EB, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340(15):1144–53.CrossRefPubMed
14.
Vale CL. Reducing uncertainties about the effects of chemo-radiotherapy for cervical cancer: individual patient data meta-analysis. Cochrane Gynaecol Cancer Group. 2013. doi:10.1002/14651858
15.
Nag S, Erickson B, Thomadsen B, et al. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cancer. Int J Radiat Oncol Biol Phys. 2000;48(1):201–11.CrossRefPubMed
16.
Hareyama M, Sakata K, Oouchi A, et al. High dose rate versus low dose rate intracavitary therapy for carcinoma of the uterine cervix: a randomized trial. Cancer. 2002;94(1):117–24.CrossRefPubMed
17.
Nakano T, Kato S, Ohno T, et al. Long-term results of high- dose-rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix. Cancer. 2005;103(1):92–101.CrossRefPubMed
18.
Perez CA, Grigsby PW, Lockett MA, et al. Radiation therapy morbidity in carcinoma of the uterine cervix: dosimetric and clinical correlation. Int J Radiat Oncol Biol Phys. 1999;44(4):855–66.CrossRefPubMed
Metadata
Title
Induction Chemotherapy Followed by Concurrent Chemoradiation in the Management of Different Stages of Cervical Carcinoma: 5-year Retrospective Study
Authors
Kamlesh Kumar Harsh
Akhil Kapoor
Murali Paramanandhan
Satya Narayan
Ramesh Purohit
Pramila Kumari
Mukesh Kumar Singhal
Publication date
01-10-2016
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue 5/2016
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-015-0699-4

Other articles of this Issue 5/2016

The Journal of Obstetrics and Gynecology of India 5/2016 Go to the issue

Original Article

Pros and Cons of Adding of Neoadjuvant Chemotherapy to Standard Concurrent Chemoradiotherapy in Cervical Cancer: A Regional Cancer Center Experience

Editorial

Getting Older Women Pregnant: Contemporary Thoughts

Original Article

Types and Outcome of Fetal Urinary Anomalies in Low Resource Setting Countries: A Retrospective Study

Original Article

Defining the Role of Neoadjuvant Chemotherapy Followed by Surgery in Locally Advanced Cancer Cervix: A Meta-analysis of Phase III Trials

Case Report

Malignant Melanoma of Vagina: A Report and Review of Literature

Case Report

Pulseless Disease in Pregnancy: A Rare Case