Skip to main content
SpringerLink
Log in

Neoadjuvant Chemotherapy in the Management of Cervical Carcinoma

  • Chapter
  • First Online:
Pelvic Cancer Surgery

  • 1942 Accesses

Abstract

Cervical Carcinoma is a significant health burden with 530,000 women diagnosed worldwide in 2008. The incidence has been falling in the UK and western countries, largely due to the national screening programs, but more than 80 % of cases are diagnosed in the developing world. The majority of invasive cases diagnosed are locally advanced FIGO stage IB2-IVA. For more than a decade the standard of care for women with locally advanced disease has been chemo-radiotherapy due to a significant survival advantage with the addition of concurrent platinum based chemotherapy to radiotherapy. An individual patient data meta-analysis based on 18 trials from 11 countries confirmed the benefit of chemo-radiotherapy with a 6 % improvement in 5-year overall survival (OS) from 60 to 66 %. Investigators have focused on improving these survival rates with the addition of chemotherapy before (neoadjuvant, NACT) radical radiotherapy or surgery. Most of these trials were conducted in the pre chemo-radiotherapy era. This chapter will address this approach to treatment: the current evidence and the future approach.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. GLOBOCAN. Cancer fact sheet: cervical cancer incidence, mortality and prevalence worldwide in 2008. 2008 [cited 2013 April 20]; Available from: http://globocan.iarc.fr/factsheet.asp.

  2. ONS. Office for National Statistics: Cancer Registrations. 2013 [cited 2013 April 20]; Available from: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations.

  3. Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int J Gynecol Obstet. 2009;105:107–8.

    Article  Google Scholar 

  4. Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, Clarke-Pearson DL, Insalaco S. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340(15):1144–53.

    Article  CAS  PubMed  Google Scholar 

  5. Keys HM, Bundy BN, Stehman FB, Muderspach LI, Chafe WE, Suggs CL, Walker JL, Gersell D. Cisplatin, radiation and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999;340(15):1154–61.

    Article  CAS  PubMed  Google Scholar 

  6. NCI. NCI issues clinical announcement on cervical cancer: chemotherapy plus radiation improves survival. NIH News Advisory 1999 [updated cited 22 Feb 1999]; Available from: http://www.nih.gov/news/pr/feb99/nci-22.htm.

  7. McCormack M, Brown RSD, Birtle AJ. A national audit of chemo-radiation practice for cervical carcinoma in the United Kingdom. Royal College of Radiologists Annual Scientific Meeting 2001. Clin Oncol. 2001;13:318–9.

    Google Scholar 

  8. CCCMAC. Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomised trials. Chemoradiotherapy for Cervical Cancer Meta-Analysis Collaboration. J Clin Oncol. 2008;26:5802–12.

    Article  Google Scholar 

  9. Lissoni AA, Colombo N, Pellegrino A, Parma G, Zola P, Katsaros D, Chiari S, Buda A, Landoni F, Peiretti M, Dell’anna T, Fruscio R, Signorelli M, Grassi R, Floriani I, Fossati R, Torri V, Rulli E. A phase II, randomized trial of neo-adjuvant chemotherapy comparing a three-drug combination of paclitaxel, ifosfamide, and cisplatin (TIP) versus paclitaxel and cisplatin (TP) followed by radical surgery in patients with locally advanced squamous cell cervical carcinoma: the Snap-02 Italian Collaborative Study. Ann Oncol. 2009;20(4):660–5.

    Article  CAS  PubMed  Google Scholar 

  10. Eiriksson L, Covens A. Advancing fertility-sparing treatments in cervical cancer: where is the limit? Gynecol Oncol. 2012;126(3):317–8.

    Article  PubMed  Google Scholar 

  11. Li R, Lu S, Si J, Liu B, Wang H, Mei Y, Linghu H. Prognostic value of responsiveness of neoadjuvant chemotherapy before surgery for patients with stage IB2/IIA2 cervical cancer. Gynecol Oncol. 2013;128(3):524–9.

    Article  CAS  PubMed  Google Scholar 

  12. Gonzalez-Martin A, Gonzalez-Cortijo L, Carballo N, Garcia JF, Lapuente F, Rojo A, Chiva LM. The current role of neoadjuvant chemotherapy in the management of cervical carcinoma. Gynecol Oncol [Meta-Analysis Review]. 2008;110(3 Suppl 2):S36–40.

    Article  Google Scholar 

  13. Tierney JF, Stewart LA, Parmar MKB. Neoadjuvant chemotherapy for locally advanced cervical cancer meta-analysis collaboration. Neoadjuvant chemotherapy for locally advanced cervical cancer: a systematic review and meta-analysis of individual patient data from 21 randomised trials. Eur J Cancer. 2003;39(17):2470–86.

    Article  Google Scholar 

  14. Eddy GL, Bundy BN, Creasman WT, Spirtos NM, Mannel RS, Hannigan E, O’Connor D. Treatment of (“bulky”) stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group. Gynecol Oncol. 2007;106(2):362–9.

    Article  CAS  PubMed  Google Scholar 

  15. Mossa B, Mossa S, Corosu L, Marziani R. Follow-up in a long term randomized trial with neoadjuvant chemotherapy for squamous cell cervical carcinoma. Eur J Gynaecol Oncol. 2010;31(5):497–503.

    CAS  PubMed  Google Scholar 

  16. Park D. Phase II, trial of neoadjuvant paclitaxel and cisplatin in uterine cervical cancer. Gynecol Oncol. 2004;92(1):59–63.

    Article  CAS  PubMed  Google Scholar 

  17. Mori T, Hosokawa K, Kinoshita Y, Watanabe A, Honjo H. Neoadjuvant chemotherapy with weekly carboplatin and paclitaxel for locally advanced cervical carcinoma. Int J Gynecol Cancer. 2008;18:85–9.

    Article  CAS  PubMed  Google Scholar 

  18. Dueñas-Gonzalez A, López-Graniel C, González-Enciso A, Cetina L, Rivera L, Mariscal I, Montalvo G, Gómez E, de la Garza J, Chanona G, Mohar A. A phase II study of multimodality treatment for locally advanced cervical cancer: neoadjuvant carboplatin and paclitaxel followed by radical hysterectomy and adjuvant cisplatin chemoradiation. Ann Oncol. 2003;14(8):1278–84.

    Article  PubMed  Google Scholar 

  19. Rydzewska L, Tierney J, Vale CL, Symonds PR. Neoadjuvant chemotherapy plus surgery versus surgery for cervical cancer. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007406. doi:10.1002/14651858.CD007406.pub2.

  20. Kim HS, Sardi JE, Katsumata N, Ryu HS, Nam JH, Chung HH, Park NH, Song YS, Behtash N, Kamura T, Cai HB, Kim JW. Efficacy of neoadjuvant chemotherapy in patients with FIGO stage IB1 to IIA cervical cancer: an international collaborative meta-analysis. Eur J Surg Oncol. 2013;39(2):115–24.

    Article  CAS  PubMed  Google Scholar 

  21. McCormack M, Ledermann JA, Hall-Craggs MA, Symonds RP, Warwick V, Simonds H, Fernando I, Hackshaw A. A phase II study of weekly neoadjuvant chemotherapy followed by radical chemoradiation for locally advanced cervical cancer. J Clin Oncol. 2009;27(15s):5586.

    Google Scholar 

  22. McCormack M, Kadalayil L, Hackshaw A, Hall-Craggs MA, Symonds RP, Warwick V, Simonds H, Fernando I, Hammond M, James L, Feeney A, Ledermann J. A phase II study of weekly neoadjuvant chemotherapy followed by radical chemoradiation for locally advanced cervical cancer. Br J Cancer. 2013;108:2464–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncology, University College London Hospital, London, UK

    Gemma K. D. Eminowicz MBChB, MRCP, MSc, FRCR & Mary McCormack BSc, MSc, PhD, MBBS, FRCR

Authors
  1. Gemma K. D. Eminowicz MBChB, MRCP, MSc, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mary McCormack BSc, MSc, PhD, MBBS, FRCR
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mary McCormack BSc, MSc, PhD, MBBS, FRCR .

Editor information

Editors and Affiliations

  1. Urology, University Hospital of North Norway, Tromsø, Norway

    Hitendra R.H. Patel

  2. University College London Hospital, London, United Kingdom

    Tim Mould

  3. Laparoscopic and Robotic Surgery, University of Rochester Medical Center, Rochester, New York, USA

    Jean V. Joseph

  4. Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA

    Conor P. Delaney

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Eminowicz, G.K.D., McCormack, M. (2015). Neoadjuvant Chemotherapy in the Management of Cervical Carcinoma. In: Patel, H., Mould, T., Joseph, J., Delaney, C. (eds) Pelvic Cancer Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4258-4_35

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4258-4_35

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4257-7

  • Online ISBN: 978-1-4471-4258-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation