Abstract
BackgroundFew studies investigated the effectiveness of adjuvant chemotherapy (ACT) in patients with optimal response to neoadjuvant chemotherapy (NACT), and an optimal number of treatment cycles for these patients remains unknown.MethodsA total of 261 Chinese patients with FIGO stage IB2-IIB cervical cancer who obtained an optimal response to NACT were included after radical surgery, and the disease-free survival (DFS) and overall survival (OS) of these patients treated with different cycles of postoperative ACT were compared using the Log-rank test and multivariate analysis.ResultsWe found that the prognosis of optimal responders treated with postoperative ACT was significantly better than those without further adjuvant therapy. The multivariate analysis showed that postoperative ACT was an independent prognostic factor for DFS. However, there was no significant difference in the DFS and OS between patients who had three cycles of ACT and those with six cycles. Further analysis revealed a significant association of six cycles of ACT with the risk of leukopenia, nausea/vomiting, and rash.ConclusionOur data suggest that additional three cycles of ACT after surgery may improve the clinical outcome of optimal responders in terms of DFS, OS, and drug toxicity.
Highlights
Cervical cancer is the second most common gynecologic cancer in developing countries
Many studies reported that the survival time of optimal pathological responders was significantly longer than that of non-optimal responders, Postoperative Adjuvant Chemotherapy in Cervical Cancer B
The possible explanation is the different cycle number of neoadjuvant chemotherapy (NACT) because, in Asian countries, such as China and Japan, two cycles of platinum-based NACT were widely accepted for patients
Summary
Cervical cancer is the second most common gynecologic cancer in developing countries. There were still around 20% to 30% of patients treated with NACT+RS suffering from pelvic and/or extra-pelvic recurrence in 5 years, and long-term overall survival (OS) is still unsatisfactory [4] For these reasons, postoperative adjuvant chemotherapy (ACT) has been employed with the intention of radical cure [5]. Few studies investigated the effectiveness of adjuvant chemotherapy (ACT) in patients with optimal response to neoadjuvant chemotherapy (NACT), and an optimal number of treatment cycles for these patients remains unknown. Methods: A total of 261 Chinese patients with FIGO stage IB2-IIB cervical cancer who obtained an optimal response to NACT were included after radical surgery, and the diseasefree survival (DFS) and overall survival (OS) of these patients treated with different cycles of postoperative ACT were compared using the Log-rank test and multivariate analysis. Conclusion: Our data suggest that additional three cycles of ACT after surgery may improve the clinical outcome of optimal responders in terms of DFS, OS, and drug toxicity
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