Improving the Efficacy and Safety of Concurrent Chemoradiotherapy by Neoadjuvant Chemotherapy: A Randomized Controlled Study of Locally Advanced Cervical Cancer with a Large Tumor

Abstract

In the present study, we conducted a prospective randomized trial to compare the efficacy and safety of TP-based NACT+CCRT vs. CCRT in LACC patients with large tumor masses. The majority of the participants in this study came from Guizhou, China's poorest province. Because of financial and healthcare constraints, most cervical cancer patients in this region are in an advanced stage and have a sizeable local mass when they are admitted. Our study showed that compared to CCRT, NACT+CCRT might could improve the treatment completion rate, increase CR and OS, and distant metastases and radiation-related adverse effects for LACC patients with large tumor masses. However, further validation of this result requires extended follow-up periods. The complete response (CR) rate of patients in the NACT+CCRT group was significantly higher than in the CCRT group (87.7%vs 67.6%, X2 = 54.540, P = 0.000). In the NACT+CCRT group, the 1- and 2-year overall survival (OS) rates were significantly higher than those in the CCRT group (96% vs 89% and 89% vs 79%, X2 = 5.737, P = 0.017). Additionally, the rate of recurrences and distant metastases was significantly lower in the NACT+CCRT group than in the CCRT group (4.11% vs 7.35%, X2 = 4.059, P = 0.021). Most treatment-related adverse events in both groups were grade 3, with the CCRT group having a considerably greater occurrence than the NACT+CCRT group. From the above results we found that Compared to CCRT, NACT+CCRT might could improve the treatment completion rate, increase CR rate and 1- and 2-year OS rates, and reduce distant metastases rate and adverse effects for LACC patients with large tumor masses. The majority of the participants in this study came from Guizhou, China's poorest province. Because of financial and healthcare constraints, most cervical cancer patients in this region are in an advanced stage and have a sizeable local mass when they are admitted. Our study showed that compared to CCRT, NACT+CCRT might could improve the treatment completion rate, increase CR and OS, and distant metastases and radiation-related adverse effects for LACC patients with large tumor masses. However, further validation of this result requires extended follow-up periods.