Neoadjuvant Paclitaxel-Carboplatin Followed by Concurrent Chemoradiotherapy versus Concurrent Chemoradiotherapy Alone...

Concurrent chemoradiotherapy (CCRT) remains the standard of care for locally advanced cervical cancer, yet recurrence and treatment-related toxicity continue to limit outcomes. Neoadjuvant chemotherapy using a Paclitaxel-Carboplatin regimen followed by CCRT (NACT-CCRT) been proposed to improve therapeutic response while minimizing systemic toxicity. This study aimed to compare the efficacy and safety of NACT-CCRT versus CCRT alone in patients with locally advanced (FIGO IIA-IIIC) and metastatic (stage IVA) cervical cancer.

Prospective cohort study was conducted at Hasan Sadikin General Hospital, Bandung, between July 2024 and September 2025. Sixty-five eligible patients were enrolled using convenience sampling, comprising 32 in the NACT+CCRT group and 33 in the CCRT group. Treatment response was assessed according to RECIST 1.1 criteria, and tumour size reduction was measured using pelvic MRI before and after therapy. Statistical analysis included independent t-tests, Chi-square tests, and Repeated Measures ANOVA, with significance set at p<0.05.

Patients receiving NACT-CCRT achieved higher complete and overall response rates (100%) compared to those treated with CCRT alone. Tumour reduction exceeding 75% was observed in both groups, with the NACT+CCRT group show lower mortality rate. No significant increase in treatment-related toxicity was noted.

The combination of Paclitaxel Carboplatin-based neoadjuvant chemotherapy followed by chemoradiation appears to be an effective and well-tolerated approach for selected patients with locally advanced cervical cancer, particularly those with good performance status and large tumours. Nevertheless, larger randomized controlled trials and biomarker-driven studies are needed to validate these findings and identify subgroups that may achieve the most durable clinical benefit.