DEFINITIVE CONCURRENT CHEMORADIOTHERAPY WITH OR WITHOUT INDUCTION CHEMOTHERAPY FOR LOCALLY ADVANCED CERVICAL CANCER: A RETROSPECTIVE COHORT STUDY

Objectives: To evaluate the efficacy and safety of concurrent chemoradiotherapy (CCRT) with or without induction chemotherapy (IC) in patients with unresectable locally advanced cervical cancer (LACC). Methods: A retrospective cohort study was conducted on 159 patients with stage II–IVA cervical cancer who received CCRT with weekly Cisplatin, with or without weekly Paclitaxel–Carboplatin induction chemotherapy, at K Hospital between January 2024 and May 2025. Results: Overall, no statistically significant differences were observed between the IC and non-IC groups in terms of age, stage distribution and histopathology (p > 0.05). At a median follow-up of 18.7 months (range, 14.4 – 23.3 months), the objective response rate (ORR) after induction chemotherapy was 85.7%. Following CCRT, the ORR in the IC plus CCRT group and the CCRT-alone group was 80.7% and 90.2%, respectively (p = 0.180). The 12-month progression-free survival (PFS) rates were 70.2% for the IC plus CCRT group and 74.5% for the CCRT-alone group (p = 0.555). The incidence of grade ≥ 3 hematological adverse events was higher in the induction chemotherapy group compared to the CCRT-alone group, including anemia (25.6% vs. 6.9%, p = 0.001), neutropenia (42.1% vs. 18.6%, p = 0.001), and thrombocytopenia (15.8% vs. 2%, p = 0.001). The rates of radiation-induced proctitis and cystitis in the two groups were 15.8% vs. 5.9% (p = 0.04) and 28.1% vs. 8.8% (p = 0.01), respectively. Conclusions: Induction chemotherapy combined with concurrent chemoradiotherapy demonstrated no statistically significant differences in ORR and 12-month PFS, but significantly increased grade ≥ 3 hematological toxicities as well as the incidence of radiation proctitis and cystitis.