Neoadjuvant intraarterial chemotherapy and chemoembolization in locally advanced cervix cancer

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cervical Cancer
Locoregional Treatment
Presenter Odiljon Akhmedov
Citation Annals of Oncology (2018) 29 (suppl_9): ix79-ix86. 10.1093/annonc/mdy436
Authors O. Akhmedov, N. Zakhirova, N. Umarova
  • Gynecology, National Cancer Research Center of Uzbekistan, 100174 - Tashkent/UZ

Abstract

Background

Cervix cancer is the most frequent cancer disease in woman. In present time treatment for locally advanced cervix cancer is radiation (RT) with concomitant platinum-based chemotherapy (CT).

Methods

Over 9 years, 246 consecutive women with FIGO stage IIb-IVa cervix cancer were enrolled. Treatment consisted of bilateral internal iliac artery infusion of methotrexate 50 mg/m2, day 1, 5 Ftouracil 1000mg/m2, day2, cisplatin 100 mg/m2, day3 for two courses by 3 weeks. And in 64 patients chemoembolization of bilateral internal iliac artery with doxorubicin 40 mg/m2, were done. Stage III patients who responded to neoadjuvant intraarterial chemotherapy or chemoembolization and stage II b patients underwent radical hysterectomy with pelvic lymphadenectomy. Stage III patients not responding to neoadjuvant chemotherapy receivedchemoembolization, and all stage IV patients were treated with pelvic radiotherapy.

Results

Complete response was achieved in 36 (14.6%) of 246 patients, while a partial response was not in 196 (79. 6%), stable disease in 10 (4.1%) and progressing of disease in 4 (1,62%). 48 patients with stage IIIb disease were able to undergo surgery. The 5-year disease-free survival was 82.0% in patients with stage IIb and 57.3% in patients with stage III. In stage IIIb, the 5-year disease-free survival in patients receiving surgery (65.8%) was higher than the disease-free survival for those receiving radiotherapy (41.2%) (P < 0.05). Grade 3 or 4 leukopenia developed in 82 (33.3%) patients. Nausea and vomiting of grade 2 or higher occurred in128 (52.1%). Creatinine clearance transiently decreased (>/= grade 2) in 18.6%. Patients negative for serum squamous cell carcinoma-associated antigen (SCC) responded better to neoadjuvant intraarterial chemotherapy or embolization than to SCC-positive cases, and SCC-negative survival was significantly better than SCC-positive survival (P < 0.05).

Conclusions

Neoadjuvant intraarterial chemotherapy and chemoembolization was safely performed, and a survival benefit followed radical surgery with or without radiotherapy after response to neoadjuvant intraarterial chemotherapy or chemoembolization.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

National Cancer Center of Uzbekistan.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.