학술논문
Neoadjuvant chemotherapy for patients with international federation of gynecology and obstetrics stages IB3 and IIA2 cervical cancer: a multicenter prospective trial
Document Type
article
Author
Yingjie Hu; Yingyan Han; Yuanming Shen; Jing Chen; Yaheng Chen; Yile Chen; Junying Tang; Min Xue; Li Hong; Wenjun Cheng; Danbo Wang; Zhiqing Liang; Yifeng Wang; Qinghua Zhang; Hui Xing; Yu Zhang; Cunjian Yi; Zhiying Yu; Youguo Chen; Manhua Cui; Cailing Ma; Hongying Yang; Ruizhen Li; Ping Long; Yu Zhao; Pengpeng Qu; Guangshi Tao; Lihua Yang; Sufang Wu; Zhihua Liu; Ping Yang; Weiguo Lv; Xing Xie; Ding Ma; Hui Wang; Kezhen Li
Source
BMC Cancer, Vol 22, Iss 1, Pp 1-16 (2022)
Subject
Language
English
ISSN
1471-2407
Abstract
Abstract Background Preoperative neoadjuvant chemotherapy (NACT) has been widely used in developing countries for the treatment of patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB3 and IIA2 cervical cancer. However, the effectiveness of NACT and treatment options for NACT-insensitive patients have been concerning. This study will assess prognostic differences between NACT and primary surgery treatment (PST), determine factors associated with prognosis, and explore better adjuvant treatment modalities for NACT-insensitive patients. Methods This study analyzed clinical characteristics, pathological characteristics, treatment options, and follow-up information of 774 patients with FIGO stages IB3 and IIA2 cervical cancer from 28 centers from January 2016 to October 2019 who participated in a multicenter, prospective, randomized controlled trial. Results For patients undergoing NACT, the 5-year OS and PFS rate was 85.8 and 80.5% respectively. They were similar in the PST group. There was no significant difference in OS and PFS between clinical response (CR)/partial response (PR) groups and stable disease (SD)/progressive disease (PD) groups. Apart from deep cervical invasion (p = 0.046) affecting OS for patients undergoing NACT, no other clinical and pathological factors were associated with OS. 97.8% of NACT-insensitive patients opted for surgery. If these patients did not have intermediate- or high-risk factors, whether they had undergone postoperative adjuvant therapy was irrelevant to their prognosis, whereas for patients with intermediate- or high-risk factors, adjuvant chemotherapy resulted in better PFS (chemotherapy vs. no therapy, p