Neoadjuvant chemotherapy via different approaches for the treatment of cervical carcinoma in young female patients: comparison of the therapeutic effect

Objective To compare the efficacy and side- effects of preoperative neoadjuvant uterine arterial chemoembolization and venous chemotherapy in treating cervical cancer in young female patients.Methods A total of 241 young females(≤35 years old) with cervical cancer were enrolled in this study. The clinical data were retrospectively analyzed. The patients were divided into group A(n=63) and group B(n=57). Patients in group A received preoperative neoadjuvant uterine arterial chemoembolization with subsequent surgery, while patients in group B were treated with preoperative neoadjuvant intravenous chemotherapy followed by surgery. The chemotherapy scheme included carboplatin(50 mg/m2) and gemcitabine(1 000 mg/m2). The short- term effect, the amount of blood loss during the surgery, pathological findings and the side- effects of the two groups were compared. The Kaplan- Meier method was used to calculate survival rate, and the log- rank test was used for survival difference analysis. Results The short- term response rate of group A was 90.5%, which was significantly higher than that of group B(71.9%), the difference between the two groups was statistically significant(χ2=7.5, P0.05). The resection rate of group A was 95.2%, which was higher than that of group B(84.2%). The amount of intra- operative blood loss of group A and group B was(443±263) ml and(695±312) ml respectively, the difference was statistically significant(t=4.802, P0.05). The pathological complete remission of group A and group B was 9.5%(6/63) and 5.3%(3/57)respectively; the differences in postoperative pathological results between the two groups were statistically significant(χ2=12.3, P0.05). The side effect of group A was milder than that of group B(P0.05). The 5-year progression- free survival(PFS) rate of group A and group B was 73.0% and 54.4% respectively(χ2=4.471, P0.05); and the overall survival(OS) rate of group A and group B was 77.8% and 63.2% respectively(χ2=3.022, P0.05). In both groups, the clinical stage, the pathological grade and the size(≥ 4 cm) of the tumor were the main factors that could influence the prognosis in young females with cervical cancer(P0.05).Conclusion The short- term efficacy of preoperative uterine artery chemoembolization is better than that of preoperative intravenous chemotherapy for the treatment of cervical cancer in young female patients. Besides,this therapy carries mild side effect, and it can improve the 5- year progression- free survival rate, although the long- term survival rate has not been obviously improved.