Neoadjuvant chemotherapy followed by extended-field concurrent chemoradiotherapy in squamous cell carcinoma of the cervix with positive paraaortic lymph nodes: two cases

Purpose: To report the feasibility of neoadjuvant chemotherapy (NAC) followed by extended-field concurrent chemoradiotherapy (EF-CCRT) for squamous cell carcinoma of the cervix (CC) with paraaortic lymph node (PAN) metastasis. Methods: Two patients were diagnosed with CC with positive PAN, and received two courses of cisplatin (120 mg/m(2)) in a neoadjuvant setting. They then received extended-field, external-beam radiotherapy (50.4 Gy) followed by intracavitary brachytherapy concurrently with cisplatin (20 mg/m(2) x 5 days) at 21-day intervals. Results: EF-CCRT was interrupted in one patient for five days because of grade 4 neutropenia. No severe late toxicities were observed. The two patients are alive with no evidence of recurrence at present. Conclusions: NAC followed by EF-CCRT is feasible and may improve the survival outcome of patients with CC with positive PAN.

Cervical cancer; Paraaortic lymph node metastasis; Neoadjuvant chemotherapy; Concurrent chemoradiotherapy

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