Authors
Gynecology & Oncology Department, School of Medicine, Tehran University of Medical Science, Tehran, Iran
Abstract
Aims: Cervical cancer is one of the most common cancer in the female since 1990. Neoadjuvant chemotherapy (NACT) uses before surgery, especially in countries with limited radiotherapy facilities. The aim of the present review was to study the effect of NACT before radical surgery in comparison with other treatments and various clinical outcomes.
Information and Methods: This study is a systematic review and includes previous publishes about cervical cancer and effect of NACT before radical surgery. Over 40 previous studies were reviewed, none of them was case report, at least 5 studies were randomized clinical trials and 6 of them were meta-analysis or systematic review.
Findings: NACT before surgery demonstrates advantages to reduce the rate of lymph node metastasis and parametrial infiltration, so improves progression-free survival in patients with pelvic lymph node invasion (Approximately 35% of stage IB2–IIB bulky). NACT also decreases tumor volume and minimizes the need for adjuvant radiotherapy, thus NACT under consideration of quality of life and cost-effectiveness should be recommended. NACT is really effective in decreasing incidence of pathological risk factors.
Conclusion: NACT response associated with the stage of diagnosis, tumor size and pathology of the specimen (Squamous tumor has a better response than a non-squamous tumor). NACT seems to be feasible in the management of stage IB bulky cervical cancer, NACT followed by surgery represent an alternative to primary chemoradiotherapy in young and sexually active patients.
Keywords
- Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108. [DOI:10.3322/canjclin.55.2.74] [PMID]
- Ma X, Yu H. Global Burden of Cancer. Yale J Biol Med. 2006;79(3-4):85-94.
- World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization; 2008.
- Kim HS, Sardi JE, Katsumata N, Ryu HS, Nam JH, Chung HH, et al. Efficacy of neoadjuvant chemotherapy in patients with FIGO Stage IB1 to IIA cervical cancer: An international collaborative meta-analysis. Eur J Surg Oncol. 2013;39(2):115-24. [DOI:10.1016/j.ejso.2012.09.003] [PMID]
- Quinn MA, Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, et al. Carcinoma of the cervix uteri. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynecol Obstet. 2006;95 Suppl 1:S43-103. [DOI:10.1016/S0020-7292(06)60030-1]
- Whitney CW, Sause W, Bundy BN, Malfetano JH, Hannigan EV, Fowler WC Jr, et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in Stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: A Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol. 1999;17(5):1339-48. [DOI:10.1200/JCO.1999.17.5.1339] [PMID]
- Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340(15):1137-43. [DOI:10.1056/NEJM199904153401501] [PMID]
- Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340(15):1144-53. [DOI:10.1056/NEJM199904153401502] [PMID]
- Keys HM, Bundy BN, Stehman FB, Muderspach LI, Chafe WE, Suggs CL, et al. Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky Stage IB cervical carcinoma. N Engl J Med. 1999;340(15):1154-61. [DOI:10.1056/NEJM199904153401503] [PMID]
- Peters WA, Liu PY, Barrett RJ, Stock RJ, Monk BJ, Berek JS, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000;18(8):1606-13. [DOI:10.1200/JCO.2000.18.8.1606] [PMID]
- Thomas GM. Improved treatment for cervical cancer--concurrent chemotherapy and radiotherapy. N Engl J Med. 1999;340(15):1198-200. [DOI:10.1056/NEJM199904153401509] [PMID]
- Green JA, Kirwan JM, Tierney JF, Symonds P, Fresco L, Collingwood M, et al. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: A systematic review and meta-analysis. Lancet. 2001;358(9284):781-6. [DOI:10.1016/S0140-6736(01)05965-7]
- Tierney JF, Vale C, Symonds P. Concomitant and neoadjuvant chemotherapy for cervical cancer. Clin Oncol (R Coll Radiol). 2008;20(6):401-16. [DOI:10.1016/j.clon.2008.04.003] [PMID]
- Kokka F, Bryant A, Brockbank E, Powell M, Oram D. Hysterectomy with radiotherapy or chemotherapy or both for women with locally advanced cervical cancer. Cochrane Database Syst Rev. 2015;(4):CD010260. [DOI:10.1002/14651858.CD010260.pub2] [PMID]
- Chai Y, Wang J, Wang T, Shi F, Wang J, Su J, et al. Cost-effectiveness of radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO Stage IIB cervical cancer. Onco Targets Ther. 2016;9:349-54. [DOI:10.2147/OTT.S90798] [PMID]
- Zhou J, Li X, Huang K, Jia Y, Tang F, Sun H, et al. Young cervical cancer patients may be more responsive than older patients to neoadjuvant chemotherapy followed by radical surgery. PLoS One. 2016;11(2):e0149534. [DOI:10.1371/journal.pone.0149534] [PMID]
- Katsumata N, Yoshikawa H, Kobayashi H, Saito T, Kuzuya K, Nakanishi T, et al. Phase III randomized controlled trial of neoadjuvant chemotherapy plus radical surgery vs radical surgery alone for Stages IB2, IIA2, and IIB cervical cancer: A Japan Clinical Oncology Group trial (JCOG 0102). Br J Cancer. 2013;108(10):1957-63. [DOI:10.1038/bjc.2013.179] [PMID]
- Marita A, Sturzu D, Ordeanu C, Rancea A, Tudosescu A, Todor N, et al. Neo-adjuvant chemotherapy associated to concurrent radio-chemotherapy in locally advanced CERVICAL cancer: A feasibility study of the Institute of Oncology "Prof. Dr. Ion Chiricuta". J Radiother Med Oncol. 2013;19(1):17-22.
- Li R, Lu ST, Si JG, Liu B, Wang H, Mei YY, et al. Prognostic value of responsiveness of neoadjuvant chemotherapy before surgery for patients with Stage IB /IIA cervical cancer. Gynecol Oncol. 2013;128(3):524-9. [DOI:10.1016/j.ygyno.2012.11.006] [PMID]
- Chen H, Liang C, Zhang L, Huang S, Wu X. Clinical efficacy of modified preoperative neoadjuvant chemotherapy in the treatment of locally advanced (Stage IB2 to IIB) cervical cancer: Randomized study. Gynecol Oncol. 2008;110(3):308-15. [DOI:10.1016/j.ygyno.2008.05.026] [PMID]
- Zivanovic O, Alektiar KM, Sonoda Y, Zhou Q, Iasonos A, Tew WP, et al. Treatment patterns of FIGO Stage IB2 cervical cancer: A single-institution experience of radical hysterectomy with individualized postoperative therapy and definitive radiation therapy. Gynecol Oncol. 2008;111(2):265-70. [DOI:10.1016/j.ygyno.2008.07.050] [PMID]
- Wang Y, Wang G, Wei LH, Huang LH, Wang JL, Wang SJ, et al. Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement. Chin J Cancer. 2011;30(9):645-54. [DOI:10.5732/cjc.011.10050] [PMID]
- Robati M, Holtz D, Dunton CJ. A review of topotecan in combination chemotherapy for advanced cervical cancer. Ther Clin Risk Manag. 2008;4(1):213-8. [DOI:10.2147/TCRM.S1771] [PMID]
- Yang L, Guo J, Shen Y, Cai J, Xiong Z, Dong W, et al. Clinical efficacy and safety of paclitaxel plus carboplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage IB2-IIB cervical cancer. Int J Clin Exp Med. 2015;8(8):13690-8.
- Suh DH, Kim M, Kim HJ, Lee KH, Kim JW. Major clinical research advances in gynecologic cancer in 2015. J Gynecol Oncol. 2016;27(6):e53. [DOI:10.3802/jgo.2016.27.e53] [PMID]
- Iwata T, Miyauchi A, Suga Y, Nishio H, Nakamura M, Ohno A, et al. Neoadjuvant chemotherapy for locally advanced cervical cancer. Chin J Cancer Res. 2016;28(2):235-40. [DOI:10.21147/j.issn.1000-9604.2016.02.13] [PMID]
- Papadia A, Bellati F, Bogani G, Ditto A, Martinelli F, Lorusso D, et al. When does neoadjuvant chemotherapy really avoid radiotherapy? Clinical predictors of adjuvant radiotherapy in cervical cancer. Ann Surg Oncol. 2015;22 Suppl 3:S944-51. [DOI:10.1245/s10434-015-4799-2] [PMID]
- Candelaria M, Cetina L, Garcia-Arias A, Lopez-Graniel C, de la Garza J, Robles E, Duenas-Gonzalez A. Radiation-sparing managements for cervical cancer: A developing countries perspective. World J Surg Oncol. 2006;4:77. [DOI:10.1186/1477-7819-4-77] [PMID]
- Kumar A, Dutta R, Kannan U, Kumar R, Khilnani GC, Gupta SD. Evaluation of mediastinal lymph nodes using 18 F-FDG PET-CT scan and its histopathologic correlation. Ann Thorac Med. 2011;6(1):11-6. [DOI:10.4103/1817-1737.74270] [PMID]
- Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford Ret al. New response evaluation criteria in solid tumors: Revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228-47. [DOI:10.1016/j.ejca.2008.10.026] [PMID]
- Cho YH, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH. Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in Stage IB2-IIA bulky cervical cancer. J Gynecol Oncol. 2009;20(1):22-7. [DOI:10.3802/jgo.2009.20.1.22] [PMID]
- Landoni F, Sartori E, Maggino T, Zola P, Zanagnolo V, Cosio S, Ferrari F, et al. Is there a role for postoperative treatment in patients with stage Ib2-IIb cervical cancer treated with neo-adjuvant chemotherapy and radical surgery? An Italian multicenter retrospective study. Gynecol Oncol. 2014;132(3):611-7. [DOI:10.1016/j.ygyno.2013.12.010] [PMID]
- Huang K, Sun H, Chen Zh, Li X, Wang SS, Zhao X, et al. Optimal pathological response indicated better long-term outcome among patients with Stage IB2 to IIB cervical cancer submitted to neoadjuvant chemotherapy. Scientific Rep. 2016;6(28278):1-8. [DOI:10.1038/srep28278] [PMID]
- Pereira E, Cooper HH, Zelaya PG, Creasman W, Price FV, Gupta V, et al. Concurrent chemoradiation versus radiotherapy alone for the treatment of locally advanced cervical cancer in a low-resource setting. Gynecol Oncol Rep. 2017;19:50-2. [DOI:10.1016/j.gore.2016.12.006] [PMID]
- Tewari KS, Sill MW, Long HJ, Penson RT, Huang H, Ramondetta LM, et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med. 2014;370(8):734-43. [DOI:10.1056/NEJMoa1309748] [PMID]
- Bloss JD, Blessing JA, Behrens BC, et al. Randomized trial of cisplatin and ifosfamide with and without bleomycin in squamous cell carcinoma of the cervix: A gynecologic oncology group study. J Clin Oncol. 2002;20(7):1832-7. [DOI:10.1200/JCO.2002.07.045] [PMID]
- Li R, Lu ST, Si JG, Liu B, Wang H, Mei YY, et al. Prognostic value of responsiveness of neoadjuvant chemotherapy before surgery for patients with stage IB(2)/IIA(2) cervical cancer. Gynecol Oncol. 2013;128(3):524-9. [DOI:10.1016/j.ygyno.2012.11.006] [PMID]
- Waggoner SE. Cervical cancer. Lancet. 2003;361(9376): 2217-25. [DOI:10.1016/S0140-6736(03)13778-6]
- Abe A, Furumoto H, Nishimura M, Irahara M, Ikushima H. Adjuvant chemotherapy following concurrent chemoradiotherapy for uterine cervical cancer with lymphadenopathy. Oncol Lett. 2012;3(3):571-6. [DOI:10.3892/ol.2011.516] [PMID]
- Ikeda Y, Furusawa A, Kitagawa R, Tokinaga A, Ito F, Ukita M, et al. Practice patterns of adjuvant therapy for intermediate/high recurrence risk cervical cancer patients in Japan. J Gynecol Oncol. 2016;27(3):e29. [DOI:10.3802/jgo.2016.27.e29] [PMID]
- Ujihira T, Ota T, Kusunoki S, Sugimori Y, Kimura M, Kaneda H, et al. Outcome of neoadjuvant intra-arterial chemotherapy and radical hysterectomy for treatment of bulky stage IB to stage IIB uterine cervical cancer: Can postoperative irradiation be avoided?. Int J Gynecol Cancer. 2016;26(7):1258-63. [DOI:10.1097/IGC.0000000000000753] [PMID]
- Van Belle SJP. What is the value of hemoglobin as a prognostic and predictive factor in cancer?. Eur J Cancer Suppl. 2004;2(2):11-9. [DOI:10.1016/S1359-6349(03)00103-4]
- Liu SP, Yang JX, Cao DY, Shen K, Xiang Y, Lang JH. Efficacy of neoadjuvant cisplatin and 5-fluorouracil prior to surgery in FIGO Stage IB2/IIA2 cervical cancer. Mol Clin Oncol. 2014;2(2):240-4. [DOI:10.3892/mco.2013.227] [PMID]
- Han SN, Mhallem Gziri M, Van Calsteren K, Amant F. Cervical cancer in pregnant women: Treat, wait or interrupt? Assessment of current clinical guidelines, innovations and controversies. Ther Adv Med Oncol. 2013;5(4):211-9. [DOI:10.1177/1758834013494988] [PMID]
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