Neoadjuvant Chemotherapy with Paclitaxel and Nedaplatin plus Radical Surgery in Cervical Cancer during Pregnancy: A Case Report and Review of the Literature

Abstract

A 36-year-old female of Chinese Han nationality at the gestational age of 30 + 3 weeks, gravid 4, para 0, without the history of family hereditary, smoking and drinking, presented an invasive squamous cervical carcinoma. The patient complained intermittent vaginal spotting 2 years ago without any physical examination and treatment, and has a history of vaginal bleeding one month ago. She was sent to our hospital and diagnosed by colposcopy biopsy. Pelvic examination revealed a 3.5 cm cervical mass without parametrial or vaginal involvement. An ultrasound scan revealed a live intrauterine pregnancy of size consistent with gestational age, and normal fetal anatomy (Biparietal diameter 76 mm and femoral length 56 mm). The patient was staged by two gynecological oncology specialists as cervical cancer IB1 (FIGO 2014). After a complete consultation, the patient and her family refused to term pregnancy and wanted pregnancy-preserving management, they agreed with neoadjuvant chemotherapy with paclitaxel 230 mg plus nedaplatin 120 mg (body surface area =1.58 m2). Three weeks later she came back for operation and found tumor decrease (3 cm mass) and liver dysfunction such as higher ALT, AST, TBIL, and DBIL as listed in table 1.