The Efficacy and Response Predictors of Platinum-Based Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer

Cancer Management and Research

关键词: locally advanced cervical cancer;    neoadjuvant chemotherapy;    clinical response;    predictor;    prognosis;   

DOI  :  

来源: DOAJ

【 摘 要 】

Yuhui Huang,* Lin Liu,* Jing Cai, Lu Yang, Si Sun, Jing Zhao, Zhoufang Xiong, Zehua Wang Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zehua Wang; Zhoufang XiongDepartment of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, Hubei, People’s Republic of ChinaTel/Fax [phone]Email [e-mail]; [e-mail]: To assess the efficacy of platinum-based neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer (LACC) and investigate the pretreatment predictors of the response.Patients and Methods: A total of 219 patients with International Federation of Gynecology and Obstetrics (FIGO 2009) stage IB2-IIA2 LACC who received platinum-based NACT from December 2007 to December 2017 were reviewed, and their clinical-pathological characteristics and follow-up data were retrospectively collected and analyzed. The baseline characteristics of age, FIGO stage, histology, tumor differentiation, tumor size, and clinical outcomes, including post-operative pathological risk factors, overall survival (OS), and progression-free survival (PFS) were compared between the responders and non-responders.Results: The overall response rate was 58.9% (129/219), and 19 (8.7%) patients achieved pathologically complete remission. NACT responders showed significantly better OS and PFS than non-responders (POS= 0.002, PPFS= 0.002). The response to NACT was identified as an independent risk factor for OS (hazard ratio [HR] = 2.453, 95% confidence intervals [95% CI], 1.125– 5.348, P = 0.024) and PFS (HR = 2.196, 95% CI, 1.183– 4.076, P = 0.013), and patients with IB2/IIA1 and a tumor size of < 5 cm tended to receive better response than patients with IIA2 (P = 0.004) and a tumor size of ≥ 5 cm (P = 0.027).Conclusion: The response rate of platinum-based NACT was approximately 60%. The response to NACT was an independent risk factor for prognosis, and patients with earlier stage and smaller tumor tended to respond better to NACT.Keywords: locally advanced cervical cancer, neoadjuvant chemotherapy, clinical response, predictor, prognosis

【 授权许可】

Unknown