INTRODUCTION: Locally advanced cervical cancer (LACC) remains a major global health burden, particularly in low-and middle-income countries. Although concurrent chemoradiation (CCRT) is standard, residual and recurrent disease remain substantial. Consolidation chemotherapy (CCT) post CCRT may eradicate micrometastatic disease and improve outcomes. The aim of this study was to compare the efficacy and safety of definitive CCRT followed by CCT versus CCRT alone in non-metastatic LACC. MATERIAL AND METHODS: A randomized controlled trial included 100 patients with FIGO 2021 stages IIB–IVA cervical cancer at Mansoura University (April 2023–October 2024). The study arm received weekly cisplatin-containing CCRT followed by 3 cycles of paclitaxel/carboplatin. The control arm received standard CCRT. Tumor response was assessed using magnetic resonance imaging and RECIST 1.1; toxicities were graded by CTCAE v4.0. RESULTS: Four study patients died during chemoradiation. CR rates at 3 and 6 months were slightly higher in the study group (95.5%, 91.3% vs. 88%, 83.3%), but not significant. At 9, 12, and 18 months, CR was significantly higher in the study group (91.3%, 89.1%, 82.6% vs. 75.5%, 55.1%, 38%, respectively; p = 0.004–≤0.001). Disease progression occurred in 21.7% of the study group vs. 40% of controls; time to progression (TTP) was longer in the study group (18.3 vs. 15.0 months; p = 0.006). Toxicities were manageable. CONCLUSIONS: Adding CCT after CCRT improves long-term tumor response and delays progression in LACC with acceptable toxicity.
Elghamery et al. (Wed,) studied this question.