AI Article Synopsis

  • - External beam radiotherapy (EBRT) was unavailable in Uganda for nearly two years, leading to the development of a new treatment strategy involving neoadjuvant chemotherapy (NAC) for bulky cervical cancer patients.
  • - A study of 53 patients found that 75.5% completed the NAC protocol, with most receiving a platinum-taxane combination, and reported adverse events were mostly mild hematologic issues.
  • - The findings suggest that even in a resource-limited setting, most patients successfully completed NAC with manageable side effects, and some went on to receive surgery and adjuvant therapy as needed.

Article Abstract

Introduction: External beam radiotherapy (EBRT) became unavailable in Uganda from February 2016 to November 2017. Following resource stratification guidelines, an alternative treatment strategy was developed.

Methods: Bulky early stage to Stage IIIB patients received at least 3 cycles of neoadjuvant chemotherapy (NAC). Surgery was performed if adequate response was achieved and adjuvant therapy given for high risk factors. Chemotherapy versus supportive care was advised in unresectable disease. NAC protocol completion was defined as receiving at least 3 cycles of NAC followed by either surgery, chemotherapy and/or radiation, or best supportive care. The purpose of this study was to determine the completion rate of NAC and assess the adverse events associated with treatment. Data were collected through retrospective chart review.

Results: From February 2016 to November 2018, 53 evaluable patients were identified. 86.8% (46/53) of patients presented in Stage IIB or higher. The completion rate of the NAC protocol was 75.5% (40/53). 94.3% (50/53) received platinum-taxane combination. 7.6% (4/52) grade 3 adverse events occurred related to chemotherapy, all hematologic. 18.8% (10/53) patients underwent surgery with 2 aborted cases due to metastatic or inoperable disease. No adverse events related to surgery were reported. 5 patients underwent adjuvant therapy after surgery due to high risk factors or incomplete pathology findings. 26 patients received adjuvant radiation (3 brachytherapy, 23 EBRT after it became available). Reported side effects related to radiation included vaginal fibrosis and skin reactions.

Conclusion: In this limited-resource setting, majority of patients completed a NAC treatment strategy for cervical cancer with acceptable toxicities.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541667PMC
http://dx.doi.org/10.1016/j.gore.2024.101533DOI Listing

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