997P - Longterm follow up of neoadjuvant chemotherapy followed by surgery in locally advanced carcinoma of the cervix

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anticancer agents
Cervical Cancer
Therapy
Biological Therapy
Presenter RAJIB Majumder
Authors R. Majumder1, A. Mukhopadhyay2, S. Poddar3, A.N. Sen1, P. Gupta2
  • 1Surgical Oncology, NETAJI SUBHASH CHANDRA BOSE CANCER RESEARCH INSTITUTE, 700016 - KOLKATA/IN
  • 2Dept. Medical Oncology, Netaji Subhas Chandra BoseCancer Research Institute, IN-700016 - Kolkata/IN
  • 3Medical Oncology, NETAJI SUBHASH CHANDRA BOSE CANCER RESEARCH INSTITUTE, 700016 - KOLKATA/IN

Abstract

Purpose

Neoadjuvant chemotherapy in cancer of the cervix has been tested for its efficacy over the last two decades. We evaluated the outcome of patients treated with neoadjuvant chemotherapy (NACT) followed by surgery for locally advanced bulky cancer of cervix.

Methods

From July 2005 to August 2008 we treated 117 patients (median age 47 years, range 38 years to 70 years) of locally advanced or bulky cancer of the cervix (stage IB2 to IIB) at Netaji Subhas Chandra Bose Cancer Research Institute, Kolkata. The majority of the patients were of stage IIB (52%, N = 117). Squamous cell carcinoma was the most common histology (89%). All of them had undergone 2-3 cycles of platin-based chemotherapy (Inj paclitaxel 175mg/m2 + Inj Carboplatin AUC 5) repeated every 21 days. Response assessment was done 2 weeks after the 2nd cycle. Good responders were taken for surgery and the rest were given 1 more cycle. After the 3rd cycle they were assessed and good responders were taken for surgery and the rest were treated with chemoradiation.

Results

The overall response rate was 72.4%. The 5-year overall survival (OS), and disease-free survival (DFS), were 64.5% and 78%, respectively. DFS was better in NACT good responders (84% vs 68%, p = 0.04). No difference in survival (OS) was seen according to tumor size ( <8cm vs >8cm, p = 0.67) or disease stage ( FIGO IB2 vs IIA1 vs IIA2 vs IIB, p = 0.1). Chemotherapy related morbidity was seen in 37% patients, surgery was delayed due to chemo toxicity in 15% of patients. Wound healing complication was seen in 26% of patients.

Conclusion

Neoadjuvant chemotherapy followed by surgery is an alternative treatment option in locally advanced carcinoma of the cervix with acceptable morbidity and should be tested in proper clinical trials against chemoradiation.

Disclosure

All authors have declared no conflicts of interest.