Complete Metabolic Response Following Induction Chemotherapy in the INTERLACE Trial for a Patient with Locally Advanced Cervical Cancer and Complex Comorbidities

The standard treatment for locally advanced cervical cancer combines external beam radiotherapy with concurrent cisplatin-based chemotherapy followed by brachytherapy. This approach yields locoregional complete response rates of 70-90% and 5-year overall survival of 70-75% (1). The recent INTERLACE trial demonstrated that short-course induction chemotherapy (6 weeks of weekly paclitaxel + carboplatin) prior to chemoradiation significantly improves progression-free and overall survival (2). We present a 68-year-old patient with FIGO stage IIB squamous cell carcinoma of the cervix, complicated by hypertension, type 2 diabetes, chronic kidney disease, and ischemic heart disease. Written informed consent was obtained prior to treatment initiation. Enrolled in the INTERLACE protocol, she received 6 weeks of induction chemotherapy (weekly paclitaxel 80 mg/m² + carboplatin AUC2). Post-chemotherapy ¹⁸F-FDG PET/CT revealed a complete metabolic response. Pelvic irradiation was then delivered via intensity-modulated radiation therapy (IMRT) to 45 Gy in 25 fractions with weekly concurrent cisplatin. High-dose-rate (HDR) brachytherapy completed the treatment to achieve ≥80 Gy EQD2 to the tumor. Three-month follow-up PET showed no abnormal uptake. At 12 months, the patient remained in complete remission without recurrence or major late toxicity. This case demonstrates the feasibility of the INTERLACE approach in high-risk patients and highlights the value of IMRT for organ-at-risk sparing.