3-year survival rates of locally advanced cervical cancer patients undergoing neoadjuvant chemotherapy followed by chemoradiation: a study from Udonthani cancer hospital

Abstract

     This study aimed to evaluate the three-year survival rate of patients with locally advanced cervical cancer who received neoadjuvant chemotherapy (NACT) followed by concurrent chemoradiation (CCRT), as well as to identify factors associated with survival outcomes. A retrospective cohort study was conducted by reviewing the medical records of patients who underwent treatment at Udonthani Cancer Hospital between January 1, 2020, and December 31, 2024, with a total of 132 patients included. The collected data included demographic information, clinical characteristics of the disease, treatment details, and treatment-related toxicities. Descriptive statistics were used for data analysis. The survival rates were estimated using the Kaplan-Meier method of survival analysis, and factors associated with survival were analyzed using a univariate Cox proportional hazards model.

     The results showed that the majority of patients had no underlying diseases (62.88%) and most had squamous cell carcinoma (73.48%), with Stage IIB being the most common stage (32.58%). The most commonly used chemotherapy regimen was platinum/paclitaxel, administered every 3–4 weeks for two cycles. The three-year survival rate was 68.80%, and the three-year progression-free survival rate was 67.04%. A statistically significant factor associated with overall survival was the time from biopsy to initiation of the first chemotherapy cycle being less than or equal to 42 days (HRCrude​ = 2.94, 95% CI: 1.10–7.83, p = 0.0458). Additionally, a total CCRT duration of more than 56 days showed a trend toward poorer overall survival (p = 0.0743). Grade 3–4 acute toxicities were observed in 14.39% of patients during NACT and 30.30% during CCRT. Hematologic grade 3–4 toxicities occurred in 12.12% and 21.97% of patients during NACT and CCRT, respectively.