Neoadjuvant Chemotherapy with Weekly Cisplatin and Paclitaxel Followed by Chemoradiation for Locally Advanced Cervical Cancer

Abstract Introduction: Locally advanced cervical cancer (LACC) remains a significant therapeutic challenge, with standard treatment involving concurrent chemoradiation. Neoadjuvant chemotherapy (NACT) before chemoradiation may improve tumor shrinkage, facilitate better local control, and reduce distant metastasis. This study evaluates the efficacy and safety of weekly cisplatin and paclitaxel as neoadjuvant chemotherapy followed by chemoradiation in patients with LACC. Methods: This prospective observational study was conducted over a period of one year at R G Kar Medical College. A total of 80 patients with histologically confirmed locally advanced cervical cancer (FIGO stages IB2 to IIIB) were enrolled. Key study variables included patient age, FIGO stage, tumor histology, and Eastern Cooperative Oncology Group (ECOG) performance status. Patients received neoadjuvant chemotherapy with weekly cisplatin and paclitaxel followed by chemoradiation. Treatment response was assessed using clinical and radiological parameters, while toxicity was monitored and graded according to standard criteria. Outcomes measured included tumor response, toxicity profile, progression-free survival, and overall survival. Results: The study included 80 patients with locally advanced cervical cancer, predominantly FIGO stage IIB and squamous cell carcinoma. Following neoadjuvant chemotherapy with weekly cisplatin and paclitaxel, 85% of patients achieved an overall response (30% complete, 55% partial). Tumor size significantly decreased from 5.4 cm to 3.2 cm (p < 0.001). The treatment was well tolerated, with manageable hematological and nonhematological toxicities. At 12 months follow-up, progression-free survival was 72.5%, and overall survival was 85%. Patients with complete or partial response had significantly better survival outcomes than those with stable or progressive disease (PFS: 14 vs. 8 months, p = 0.002; OS: 18 vs. 11 months, p = 0.004). Conclusions: Weekly cisplatin and paclitaxel as neoadjuvant chemotherapy followed by standard chemoradiation is feasible and well tolerated in LACC patients, with encouraging early clinical response and survival outcomes. Further randomized controlled trials are warranted to confirm the benefit of this sequential approach compared to chemoradiation alone.