Outcome of Combined Neoadjuvant Chemotherapy and Vitamin A in Advanced Cervical Carcinoma: A Randomized Double-Blind Clinical Trial

Document Type: Research Articles

Author

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, General Hospital of Dr.Mohammad Hoessin, University of Sriwijaya, Palembang, Sumatra, Indonesia.

Abstract

Background: The latest World Health Organization (WHO) inquiry on the epidemiology of cervical cancers indicate
there are approximately 528,000 new cases per year, ranking fourth after breast, colorectal and lung cancer. The validity
of neoadjuvant chemotherapy (NAC) alone in advanced cervical cancer is still being debated. NAC induces tumor
shrinkage prior to pursuing surgery. NAC also has the benefit of sterilizing the lymph nodes and parametria, thereby
lowering the need for adjuvant therapy after surgery. This research aims to determine the impact on the treatment of
advanced cervical carcinoma with NAC, with the additional provision of Vitamin A during treatment to assess the
factors that could affect the outcome of clinical treatment. Methodology: The research methodology and design of
this study is a randomized double-blind clinical trial to compare the effects of treatment with NAC and treatment with
NAC + Vitamin A, in advanced cervical carcinoma. Both study groups received treatments consisting of a regime of
cisplatin and paclitaxel. The study was conducted at the General Hospital of Dr. Mohammad Hoesin. The total number
of patients recruited for the trial was 30 with 15 patients per treatment arm. One group received NAC consisting of
cisplatin and paclitaxel and the remaining 15 patients received NAC + Vitamin A. Results: The addition of Vitamin
A was found to be much better in influencing the clinical response in the treatment of advanced cervical carcinoma,
although this was not statistically significant. However, a larger sample size with the reported proportion of higher
positive outcome for NAC + Vitamin A may be statistically significant. Conclusion: Based on the results, Vitamin A
supplementation in the treatment of advanced cervical carcinoma with neoadjuvant chemotherapy may play a crucial
role in the treatment of cervical carcinoma.

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