Choice of imitherapy tactics for recurrent cervical cancer: experience of the Kashkadarya branch of the RSNPMC of Oncology and Radiology of the Republic of Uzbek.

Abstract

Background. Recurrent cervical cancer (CC) is a serious clinical problem, especially in patients who have previously received combination therapy. Given the limited availability of repeat irradiation and the high toxicity of surgical intervention, the search for effective chemotherapy regimens is a priority in modern gynecologic oncology. Study Objective: To evaluate the efficacy and tolerability of various chemotherapy regimens in patients with recurrent CC treated at the Kashkadarya branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology. Materials and Methods: A retrospective analysis of 39 patients with recurrent CC observed from 2016 to 2021 was conducted. All patients underwent clinical and instrumental examination (ultrasound, MRI). Two polychemotherapy regimens were used: paclitaxel + cisplatin (n=20) and gemcitabine + cisplatin (n=19). Remission, toxicity, and survival rates were assessed. Results and discussion. The highest efficacy was observed in the gemcitabine + cisplatin group: complete remission (CR) in 21.8%, partial remission in 5.16%, and stabilization in 76%. In the paclitaxel + cisplatin group, complete remission was achieved in 14% of patients, with an overall efficacy of 18%. Gemcitabine was associated with moderate grade II-III toxicity, primarily myelosuppression and gastrointestinal manifestations. Three-year survival rates were 81% and 62%, respectively (p=0.005). Conclusion. Combination chemotherapy including gemcitabine and cisplatin demonstrated superior results in the treatment of recurrent cervical cancer compared to paclitaxel + cisplatin. Considering good tolerability and high therapeutic effect, this regimen can be recommended as preferred in the treatment of this category of patients.

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