IMR Press / EJGO / Volume 42 / Issue 5 / DOI: 10.31083/j.ejgo4205140
Open Access Original Research
Neoadjuvant chemotherapy in locally advanced cervical cancer: real-world data from the Cancer Medicines Outcomes Programme (CMOP)
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1 Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, G12 0YN Glasgow, Scotland, UK
2 Department of Mathematics and Statistics, University of Strathclyde, G1 1XH Glasgow, Scotland, UK
3 Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, G4 0RE Glasgow, Scotland, UK
4 Clinical and Protecting Health Directorate, Public Health Scotland, EH12 9EB Edinburgh, Scotland, UK
Eur. J. Gynaecol. Oncol. 2021 , 42(5), 926–935; https://doi.org/10.31083/j.ejgo4205140
Submitted: 13 July 2021 | Revised: 18 August 2021 | Accepted: 6 September 2021 | Published: 15 October 2021
Abstract

Objective: To report the outcomes of neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer, we conducted a retrospective study of 126 patients. Methods: The electronic chemotherapy prescribing system was used to identify patients from the West of Scotland Cancer Network who received NACT over a 5 year period. Baseline characteristic and treatments details were collected. Association of treatment type and other variables with overall survival (OS) were analysed using Cox proportional hazards model. Results: The median follow up was 30 months. Median age was 44 years (interquartile range 34–54), 86% had squamous pathology and 93% had at least International Federation of Gynaecology & Obstetrics (FIGO) stage II disease at diagnosis. 27% had stage IV disease and 30% had para-aortic nodal involvement. NACT regimens consisted primarily of 3 weekly cisplatin/paclitaxel (63%) or carboplatin/paclitaxel (35%). 86% of patients subsequently received chemoradiotherapy (CCRT), 11% radical radiotherapy alone and the remaining patients progressed or defaulted. Three year OS was 61.8% (95% CI (Confidence Interval) 53.4–71.6). Survival was poorer in patients with neutrophil lymphocyte ratio (NLR) 5 (hazard ratio 2.8 (95% CI 1.32–5.90)) and in those not receiving CCRT (hazard ratio 2.23 (95% CI 1.01–4.91)). Conclusions: Three year OS was reasonable considering the advanced nature of the cohort and suggests that NACT is an option for women with bulky cervical cancer.

Keywords
Locally advanced cervical cancer
Neoadjuvant chemotherapy
Chemoradiotherapy
Real-world
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