920P - The role of neoadjuvant chemotherapy in management of locally advanced cancer cervix: A systemic review

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Cervical Cancer
Presenter Mohammed Osman
Citation Annals of Oncology (2014) 25 (suppl_4): iv305-iv326. 10.1093/annonc/mdu338
Authors M.A.M. Osman
  • Oncolgoy, National organization for teaching hospitals, 11321 - Cairo/EG

Abstract

Aim

Background: Cervical cancer is the second most common cancer in women. Giving chemotherapy before surgery for patients with locally advanced cancer cervix might have comparable benefit to concurrent chemoradiotherapy, and may have fewer side effects. Study Objectives: This systemic review aimed to provide comprehensive summary of the effect of neoadjuvant chemotherapy before surgery in the management of locally advanced cancer cervix towards a standard treatment for this aggressive cancer.

Methods

Searching method: The data source included the USA national library of medicine, medline search, and the National Cancer Institute PDQ Clinical Protocols. Inclusion criteria for consideration in the current systemic review included studies published between January 1997 and December 2012, histologies included squamous cell carcinoma, adenosquamous, and/or, adenocarcinoma, patients should be chemotherapy naïve or cancer cervix chemotherapy naïve, and have good performance status.

Results

Results: Searching the above scientific websites identified 49 publications, of them 18 trials were excluded because they didn't fit with the inclusion criteria of the current systemic review. Thirty-One studies were identified eligible. Data were collected from 1784 patients enrolled in the current systemic review study. The mean age was 45.2 y.o., and the mean tumour size was 4.7 cm. The most commonly used chemotherapy was cisplatin. The mean chemotherapy cycles were 2.7 cycles. Patients underwent surgery after chemotherapy by mean time of 2.5 weeks. Chemotherapy achieved an objective response rate of 84%. Survival data showed the 5 year PFS, OS were 68.8%, 74.2% respectively. Treatment protocol was tolerated with mild early toxicity profile. Leucopenia, and neutropenia were the commonest encountered side effects. Late toxicity was generally mild, and mainly included bladder dysfunction, and vaginal dehiscence. The current study assessed the quality of included studies using the Newcastle- Ottawa quality assessment scale, and generally the included studies achieved reasonable score.

Conclusions

Conclusion: Neoadjuvant chemotherapy followed by surgery is a reasonable alternative treatment option for locally advanced cancer cervix.

Disclosure

All authors have declared no conflicts of interest.