E-ISSN 2534-9821
 

Original Research 


Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer

Sailendra Narayan Parida, Lal Mohan Soy, Biswa Ranjan Routroy, Sugyan Nandan Mohanty.

Abstract
Aim: In order to treat locally advanced cervical carcinoma, our goal was to assess the effectiveness and safety of neoadjuvant chemotherapy, radical hysterectomy, postoperative radiation, and biweekly cisplatin. Materials and Method: Radical type III hysterectomy, adjuvant radiation therapy, and 6-weekly doses of cisplatin at 35 mg/m2 were given to 40 patients staged as IB2-IIIB over the period of three 20-day courses of carboplatin (area under the time plot: 5 mg/min/ml) and paclitaxel (at 170 mg/m2 by 2-h infusion both on day 2). Evaluations were made of response rate, resectability, toxicity, and lifespan. Result: There were 40 patients enrolled. Each was assessed for toxicity and responsiveness to neoadjuvant chemotherapy. 100 courses in total were given out. 94% of patients had clinical responses, with a 94% confidence range (CI) of 89.1% to 99%. 8% of the work is finished, while 85% is incomplete. The pathologically complete or nearly complete responses were observed in 16% and 19% of the 40 patients who underwent surgery (resectability: 94%); positive surgical boundaries were identified in 11% of the patients, and positive pelvic lymph nodes were seen in 19% of the patients. Adjuvant chemoradiation was scheduled for 25 patients. A median of 4 cisplatin treatments were administered together with a mean dose of 49.2 Gy over the course of 42.7 days (range, 32–60). The average brachytherapy dose was 30 Gy (range 25.4–35.4). Neutropenia grades 3 and 4 were well tolerated with neoadjuvant therapy in 11% and 2% of the courses, respectively. Adjuvant chemoradiation generally caused grade 1/2 haematological and gastrointestinal toxicity. 35 patients in all completed the entire course of therapy. The estimated overall survival in the intention-to-treat study was 78% (94% CI 61% to 87%) at a median follow-up of 20 months (range 2–25). Neutropenia grades 3 and 4 were well tolerated with neoadjuvant therapy in 11% and 2% of the courses, respectively. Adjuvant chemoradiation generally caused grade 1/2 haematological and gastrointestinal toxicity. Thirty patients in total received the full course of therapy. The estimated overall mortality in the purpose study was 78% (94% CI 61% to 87%) at a median follow-up of 20 months (range 2–25). Conclusion: The combination of neoadjuvant chemotherapy, radical hysterectomy, and adjuvant radiotherapy in addition to cisplatin is a highly effective and tolerable approach for locally advanced cervical cancer.

Key words: cervical carcinoma, neoadjuvant chemotherapy, concomitant chemoradiation, radical hysterectomy


 
ARTICLE TOOLS
Abstract
PDF Fulltext
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Sailendra Narayan Parida
Articles by Lal Mohan Soy
Articles by Biswa Ranjan Routroy
Articles by Sugyan Nandan Mohanty
on Google
on Google Scholar


How to Cite this Article
Pubmed Style

Parida SN, Soy LM, Routroy BR, Mohanty SN. Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer. Int J Med Rev Case Rep. 2022; 6(16): 59-64. doi:10.5455/IJMRCR.172-1667476767


Web Style

Parida SN, Soy LM, Routroy BR, Mohanty SN. Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer. https://www.mdpub.net/?mno=127113 [Access: January 14, 2023]. doi:10.5455/IJMRCR.172-1667476767


AMA (American Medical Association) Style

Parida SN, Soy LM, Routroy BR, Mohanty SN. Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer. Int J Med Rev Case Rep. 2022; 6(16): 59-64. doi:10.5455/IJMRCR.172-1667476767



Vancouver/ICMJE Style

Parida SN, Soy LM, Routroy BR, Mohanty SN. Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer. Int J Med Rev Case Rep. (2022), [cited January 14, 2023]; 6(16): 59-64. doi:10.5455/IJMRCR.172-1667476767



Harvard Style

Parida, S. N., Soy, . L. M., Routroy, . B. R. & Mohanty, . S. N. (2022) Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer. Int J Med Rev Case Rep, 6 (16), 59-64. doi:10.5455/IJMRCR.172-1667476767



Turabian Style

Parida, Sailendra Narayan, Lal Mohan Soy, Biswa Ranjan Routroy, and Sugyan Nandan Mohanty. 2022. Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer. International Journal of Medical Reviews and Case Reports, 6 (16), 59-64. doi:10.5455/IJMRCR.172-1667476767



Chicago Style

Parida, Sailendra Narayan, Lal Mohan Soy, Biswa Ranjan Routroy, and Sugyan Nandan Mohanty. "Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer." International Journal of Medical Reviews and Case Reports 6 (2022), 59-64. doi:10.5455/IJMRCR.172-1667476767



MLA (The Modern Language Association) Style

Parida, Sailendra Narayan, Lal Mohan Soy, Biswa Ranjan Routroy, and Sugyan Nandan Mohanty. "Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer." International Journal of Medical Reviews and Case Reports 6.16 (2022), 59-64. Print. doi:10.5455/IJMRCR.172-1667476767



APA (American Psychological Association) Style

Parida, S. N., Soy, . L. M., Routroy, . B. R. & Mohanty, . S. N. (2022) Neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation: phase II study evaluation of multimodality treatment for locally advanced cervical cancer. International Journal of Medical Reviews and Case Reports, 6 (16), 59-64. doi:10.5455/IJMRCR.172-1667476767