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The conventional treatment of Carcinoma Cervix Stage IV A, has been a judicious combination of external beam radiotherapy and intracavitary brachytherapy, which offered an alternative to radical surgery for patients with tumors larger than 4 cm confined to cervix. Adjuvant and neoadjuvant chemotherapy, however, has been tested in cervical carcinoma for many years without success. Material and Methods: Several trials with either adjuvant chemotherapy alone or sequential radiation and chemotherapy for high risk, surgically treated early stage patients have failed to show prolong survival. The objective of this study was to see feasibility in terms of local response, treatment related toxicities and pattern of relapse of neo-adjuvant chemotherapy (NACT) followed by concurrent chemoradiotherapy (CT+RT) with cisplatin and 5Flurouracil (5-FU) in FIGO stage IV A cancer cervix. Total 55 patients of Carcinoma Cervix Stage IVA were given 2-3 cycles of NACT with Cisplatin and 5-FU at 3 weekly intervals. In patent with complete response or partial response concurrent Radiotherapy was given. Result: In this study neoadjuvant chemotherapy had significantly reduced local disease prior to definitive chemoradiotherapy. It decreased appearance and controlled distant metastasis. Concurrent chemoradiotherapy increases local control at the cost of increased toxicities. Though toxicities were increased but were managed easily. Conclusion: Thus, neoadjuvant chemotherapy followed by concurrent chemoradiotherapy is a possible option for patients with FIGO Stage IVA (locally advanced) carcinoma cervix.

Feasibility of Neoadjuvant Chemotherapy followed by Concomitant Chemoradiotherapy in Figo Stage IVA Cancer Cervix