Dose-dense Paclitaxel- and Carboplatin-based Neoadjuvant Chemotherapy Followed by Surgery or Concurrent Chemo-radiotherapy in Cervical Cancer: a Preliminary Analysis

Abstract

Aim: To assess preliminary results with dose-dense neoadjuvant chemotherapy (NACT) prior to surgery or concurrent chemo-radiotherapy (CCRT) in cervical cancer.

Patients and methods: Thirty patients received weekly paclitaxel (80 mg/m²) plus carboplatin (AUC2) for 6 cycles followed by radical hysterectomy in 16 (stage Ib₂-IIb), conisation in one (stage Ib1), and CCRT in 13 (stage Ib₂-IIb). Median follow-up of survivors was 12 months (range=3-22).

Results: Among the surgically treated patients, clinical overall response rate (RR) was 82.3%, optimal pathological RR was 17.6%, and suboptimal pathological RR with intra-cervical residual disease was 41.2%. Only one patient relapsed. Among the CCRT treated patients, partial RR after NACT was 76.9% and complete RR after CCRT was 58.3%. However, 42.8% of complete responders recurred. Toxicity was acceptable.

Conclusion: Dose-dense NACT seems to achieve promising RRs with manageable toxicity in cervical cancer. Investigation on larger series with longer follow-up is warranted.

Keywords: Cervical cancer; carboplatin; concurrent chemo-radiotherapy; dose-dense neoadjuvant chemotherapy; paclitaxel; radical hysterectomy; recurrence.