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CC BY-NC-ND 4.0 · South Asian J Cancer 2025; 14(03): 404-410
DOI: 10.1055/s-0043-1776014
Original Article
Gynaecology - Cervical Section

Neoadjuvant Chemotherapy Followed by Interdigitated Brachytherapy versus Standard Chemoradiation in Locally Advanced Cervical Cancer

Authors

  • B.K. Shewalkar

    1   Department of Radiotherapy and Oncology, Government Medical College and Cancer Hospital Aurangabad, Maharashtra, India

  • Punita Pant

    1   Department of Radiotherapy and Oncology, Government Medical College and Cancer Hospital Aurangabad, Maharashtra, India

  • Jitendra Patel 

    1   Department of Radiotherapy and Oncology, Government Medical College and Cancer Hospital Aurangabad, Maharashtra, India

  • Aakanksha Patil

    1   Department of Radiotherapy and Oncology, Government Medical College and Cancer Hospital Aurangabad, Maharashtra, India
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Abstract

Aims and Objective

To compare the clinical outcomes of neoadjuvant chemotherapy followed by interdigitated brachytherapy versus standard chemoradiation in locally advanced cervical cancer.

Materials and Methods

We enrolled 108 patients with histologically confirmed carcinoma of the cervix, at International Federation of Gynecology and Obstetrics (FIGO) stages IIB to IIIC1. They were then randomized into two groups. The study group received neoadjuvant chemotherapy with paclitaxel 175 mg/m2 and carboplatin (area under the curve [AUC]: 5) at every 3 weeks, followed by external beam radiotherapy (EBRT) 45 Gy/20 fractions and concurrent cisplatin with interdigitated high dose rate intracavitary brachytherapy (HDRICBT) 5 Gy/fraction weekly for a total of four fractions. Patients in the control group received EBRT 50 Gy/25 fractions and concurrent cisplatin with sequential HDRICBT 7 Gy/fraction weekly for a total of three fractions.

Results

At the end of the study, the results of both groups were compared in terms of response to therapy and acute toxicities. A total of 108 patients were enrolled (54 in each two arms). Ninety-three patients who completed treatment were included in the analysis. The median follow-up duration was 10 months (range: 6–18 months). Complete response was observed in 24 (53.3%) and 26 (55.3%) patients, and partial response was in 12 (26.6%) and 12 (25.5%) patients in the study and control groups, respectively. Most of the acute and late toxicities were of grades 1 and 2 and comparable in both groups.

Conclusion

In a busy department where resources are limited, neoadjuvant chemotherapy (NACT) followed by EBRT with HDRICBT is an alternative option for current standard concurrent chemoradiation (CCRT) as its tolerance and toxicity are at par with CCRT.

Keywords

carcinoma cervix - neoadjuvant chemotherapy - interdigitated brachytherapy

Availability of Data and Materials

The datasets used or analyzed during the current study are available from the corresponding authors upon reasonable request.


Ethical Approval and Consent to Participate

The study was approved by the Ethics Committee of the Government Medical College and Cancer Hospital, Aurangabad, Maharashtra. Written, informed consent to participate was obtained from all the participants.




Publication History

Article published online:
19 August 2025

© 2025. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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