title: The toxicity and long-term efficacy of nedaplatin and paclitaxel treatment as neoadjuvant chemotherapy for locally advanced cervical cancer.
abstract: BACKGROUND
  The use of neoadjuvant chemotherapy (NACT) for the treatment of locally advanced cervical cancer (LACC) remains controversial. In current clinical practice, platinum-based chemotherapy is the major option for patients with LACC. However, serious adverse events have been reported after platinum-based chemotherapy treatment for LACC patients. In this study, the authors evaluated whether nedaplatin and paclitaxel (NP), as a new NACT regimen, offers less toxicity and better long-term efficacy for LACC (stages IB2-IIB) treatment. Comparisons between NP and paclitaxel and cisplatin (PC) in terms of toxicity and long-term efficacy are also presented.
  
  
  METHODS
  The authors retrospectively reviewed 252 consecutive patients with LACC, of whom 104 received NP; the others received PC. Toxicity was assessed according to the International WHO (1979) criteria for chemotherapy side effects, and the chi-squared test was used to identify whether there was a statistically significant difference in toxicity between the NP regimen and the PC regimen. A univariate and a Cox regression model were used to assess whether the patients who were administered NP were statistically significantly different from those who were administered PC with respect to the disease-free survival rate (DFS) and the overall survival rate (OS).
  
  
  RESULTS
  The overall response rate for NP and PC were 80.77% and 68.24%, respectively (P = 0.0267). The incidences of toxic reactions for NP and PC were 32.69% and 85.14%, respectively (P < 0.0001). The DFS for patients who were given the NP and the PC regimens were 81.41% and 67.28%, respectively (P = 0.014). The OS was 81.54% for patients who received the PC program and 93.89% for those who received the NP program (P = 0.0084). The NP program participants experienced a significant increase in the survival rate when compared to the group that received the PC program (DFS hazard ratio = 0.539, P = 0.0144 and OS hazard ratio = 0.354, P = 0.0077).
  
  
  CONCLUSIONS
  NP NACT followed by radical hysterectomy offers a higher response rate, lower incidence of toxic reactions and better long-term DFS and OS for patients with LACC compared with the chemotherapy regimen of PC followed by radical hysterectomy.
authors.affiliation: Department of Gynecology Oncology, The Tumor Hospital of Harbin Medical University, Harbin, P.R. China.
authors.forename: Mingzhu
authors.initials: M
authors.lastname: Yin
authors.forename: Haiyu
authors.initials: H
authors.lastname: Zhang
authors.forename: Huiyan
authors.initials: H
authors.lastname: Li
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.forename: Yunduo
authors.initials: Y
authors.lastname: Liu
authors.forename: Xiuwei
authors.initials: X
authors.lastname: Chen
authors.forename: Ge
authors.initials: G
authors.lastname: Lou
authors.forename: Kang
authors.initials: K
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D017239:Paclitaxel; D002945:Cisplatin