919PPROS AND CONS OF ADDING OF NEOADJUVANT CHEMOTHERAPY TO STANDARD CONCURRENT CHEMORADIOTHERAPY IN CERVICAL CANCER: A REGIONAL CANCER CENTER EXPERIENCE

ABSTRACT Aim: According to GLOBOCAN 2012, cancer of the uterine cervix is the fourth most common cancer among women worldwide with more than one-fifth of all such cancer cases being diagnosed in India. The present study summarizes the results of treatment in the form of disease free survival (DFS) and overall survival (OS) in bulky stage I (IB2) and locally advanced (stages II-IVA) squamous cell carcinoma of the uterine cervix. The treatment has been given in the form of neoadjuvant chemotherapy (NACT) followed by concurrent chemoradiotherapy (CCRT) in one arm and CCRT in the other arm. Methods: 713 cervical cancer patients were treated at our center from July 2007 to October 2008. The patients' data were analyzed retrospectively. Patients underwent cisplatin-fluoruracil (PF 28.6%), taxane-cisplatin-fluorouracil (TPF 21.5%), and only CCRT (49.9%). The majority of patients were in the age group 41-50 years, while stage wise, they were mainly stage IIIb (53.3%) and IIb (21.6%). DFS was observed on the basis of stage and NACT. The survival analyses were performed using the Kaplan-Meier method. All statistical calculations were done with SPSS Statistics version 20.0. Results: For cancer of the cervix treated with NACT vs. CCRT, the DFS rate at 3 years was 58.3% vs. 41.8%( p = 0.001). NACT followed by CCRT demonstrated significantly superior DFS compared with definitive CCRT, TPF [hazard ratio (HR) =0.248, 95% confidence interval (CI): 0.123-0.500; p Conclusions: TPF/PF as NACT is feasible and produces impressive responses in cancer of the cervix. The study suggests that the TPF regimen is better than PF. TPF can be used as optional neoadjuvant chemotherapy, but the hematological toxicity is more in the taxane-based regimen. Disclosure: All authors have declared no conflicts of interest.