Neoadjuvant chemotherapy with weekly paclitaxel and carboplatin followed by chemoradiation in locally advanced cervical carcinoma: a pilot study

Abstract

Objective: To evaluate role of dose dense neo-adjuvant chemotherapy (NACT) prior to standard concurrent chemo-radiation (CCRT) in locally advanced cervical cancer. Methods: Between June 2010 and December 2011, 28 patients (median age — 51 years, range, 35 to 67 years) with locally advanced cervical cancer received NACT using paclitaxel (60 mg/m²) and carboplatin (AUC-2) weekly for 6 doses. After a mean interval of 15 days (range 7–23 days), the patients then received definitive radiation and concomitant weekly infusion of cisplatin (40 mg/m² for 6 doses). Response to concurrent chemo-radiation and toxicity were end points. Results: Following NACT, 67.8% of patients responded; complete (CR) — 2(7.1%), Partial (PR) — 17 (60.7%), stable 7 (25.0%) and 2 patients (7.1%) progressed. 24 of 28 patients received CCRT; 23/24 achieved CR. 22 of 23 complete responders continue to be in CR at a median follow-up of 12 months (range, 7 to 24 months). Grade III/IV neutropenia was the main hematological toxicity seen in 28.5% and 29% of patients, respectively during NACT and CCRT. Conclusions: Neoadjuvant chemotherapy with dose dense weekly paclitaxel and carboplatin followed by standard CCRT is a feasible approach and is associated with a high response rate in locally advanced cervical cancer.