Influence of neoadjuvant chemoradiotherapy for locally advanced cervical cancer

Over the past decade, there are significant advances in the problem of studying the pathogenesis, clinical course and treatment of cervical cancer (CC). Namely the need for more favorable treatment outcomes for locally advanced cervical cancer requires the development of more effective treatments.

The aim of our work was to study the consequences of neoadjuvant chemoradiation therapy (NCRT) in the management of locally advanced cervical cancer by assessing morphological changes in the tumor tissue.

This study is based on the assessment of tissue changes as a result of treatment of patients with a confirmed diagnosis of CC T1b2-2bN0-1M0 stages between the ages of 26 and 62 years (average age 33.7 years). The patients were divided into 3 groups by randomization. The first main group consisted of 25 patients who, at the first stage, were given preoperatively 1 course of polychemotherapy with cisplatin and paclitaxel followed by radiotherapy. The second group comprised 30 patients who underwent chemoradiomodification (paclitaxel and carboplatin) at the first stage secondary to radiation therapy (NCRT group). The third group was a comparison group, in which only 20 patients underwent radiation therapy before surgical treatment. We investigated histological changes with expression of Ki- 67, bcl2, VEGF proteins evaluation of which was based on the intensity of staining and the distribution of immunopositive cells.

Results of our research of combined and complex treatment in patients with locally advanced CC testify to the advantage of our proposed scheme of NCRT, which is characterized by significant therapeutic pathomorphosis.

We can conclude about tissual pathomorphosis due to action on NCRT with changes of proliferative, apoptotic and angiogenesis process due to expression of studied proteins can be used as favorable prognostic factors and may guide therapeutic decisions for choice of manage patients with CC.