Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer--Where Does It Stand?

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Abstract
Platinum-based combination chemotherapy has been utilized in the neoadjuvant setting in locally advanced inoperable cervical cancer with the aim of improving response and survival. Neoadjuvant chemotherapy can be followed by either radiation therapy (RT) or by surgery in cases in which it seems to be appropriate. Available data indicate that preradiation chemotherapy yields no survival advantage over RT alone. However, presurgery chemotherapy may increase resectability in women with locally advanced cervical cancer to around 70 percent. Nonrandomized trials of neoadjuvant chemotherapy followed by surgery have shown some improvement in the outcome. Prospective randomized trials are needed to evaluate this approach as compared with RT alone and to define its precise role in locally advanced cervical cancer.