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Aim: To evaluate the effectiveness and side effects of the paclitaxel and carboplatin combination as neoadjuvant chemotherapy for locally advanced cervical cancer before radical hysterectomy and pelvic lymphadenectomy. Method: We selected patients with cervical cancer who having undergone neoadjuvant chemotherapy with paclitaxel and carboplatin followed by radical hysterectomy (NACT group) or only underwent primary radical surgery (PRS group) in Acharya Harihar Post Graduate Institute of Cancer, Cuttack. Data on toxicity, NACT response, surgical pathological factors, and survival were gathered and analysed. Result: The overall rate of participation (81/11) for the NACT group was 71.2%. 15.6% patients experienced total remission. The response to NACT was better in tumours that were well differentiated (P=0.010). The most frequent adverse event was myelosuppression (51.6%), although severe adverse effects were infrequent (3.3%). 40 months made up the average follow-up time (range, 5-74). When contrasted with non-NACT respondents and individuals in the PRS group, the NACT responders had considerably longer OS and PFS. Conclusions: Although LACC patients respond to the chemotherapeutic drugs, they may profit from neoadjuvant chemotherapy with paclitaxel and carboplatin.

Aim: In order to treat locally advanced cervical carcinoma, our goal was to assess the effectiveness and safety of neoadjuvant chemotherapy, radical hysterectomy, postoperative radiation, and biweekly cisplatin. Materials and Method: Radical type III hysterectomy, adjuvant radiation therapy, and 6-weekly doses of cisplatin at 35 mg/m2 were given to 40 patients staged as IB2-IIIB over the period of three 20-day courses of carboplatin (area under the time plot: 5 mg/min/ml) and paclitaxel (at 170 mg/m2 by 2-h infusion both on day 2). Evaluations were made of response rate, resectability, toxicity, and lifespan. Result: There were 40 patients enrolled. Each was assessed for toxicity and responsiveness to neoadjuvant chemotherapy. 100 courses in total were given out. 94% of patients had clinical responses, with a 94% confidence range (CI) of 89.1% to 99%. 8% of the work is finished, while 85% is incomplete. The pathologically complete or nearly complete responses were observed in 16% and 19% of the 40 patients who underwent surgery (resectability: 94%); positive surgical boundaries were identified in 11% of the patients, and positive pelvic lymph nodes were seen in 19% of the patients. Adjuvant chemoradiation was scheduled for 25 patients. A median of 4 cisplatin treatments were administered together with a mean dose of 49.2 Gy over the course of 42.7 days (range, 32–60). The average brachytherapy dose was 30 Gy (range 25.4–35.4). Neutropenia grades 3 and 4 were well tolerated with neoadjuvant therapy in 11% and 2% of the courses, respectively. Adjuvant chemoradiation generally caused grade 1/2 haematological and gastrointestinal toxicity. 35 patients in all completed the entire course of therapy. The estimated overall survival in the intention-to-treat study was 78% (94% CI 61% to 87%) at a median follow-up of 20 months (range 2–25). Neutropenia grades 3 and 4 were well tolerated with neoadjuvant therapy in 11% and 2% of the courses, respectively. Adjuvant chemoradiation generally caused grade 1/2 haematological and gastrointestinal toxicity. Thirty patients in total received the full course of therapy. The estimated overall mortality in the purpose study was 78% (94% CI 61% to 87%) at a median follow-up of 20 months (range 2–25). Conclusion: The combination of neoadjuvant chemotherapy, radical hysterectomy, and adjuvant radiotherapy in addition to cisplatin is a highly effective and tolerable approach for locally advanced cervical cancer.