{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T19:01:02Z","timestamp":1793818862989,"version":"4.6.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the short-term efficacy and safety of neoadjuvant chemoimmunotherapy (NACI) followed by radical radiotherapy (RR) in patients with locally advanced cervical cancer (LACC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 60 patients with FIGO 2018 stage IIIA-IVA cervical cancer between June 2022 and July 2024. The experimental group (n=30) received 1\u20133 cycles of NACI (anti-PD-1\/PD-L1 therapy plus platinum-based chemotherapy) followed by RR, which was administered either alone or concurrently with immunotherapy\/chemotherapy. The control group (n=30) received RR with or without concurrent chemotherapy. Treatment response was assessed using RECIST 1.1 incorporating gynecological examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After NACI, the objective response rate (ORR) was 93.3% in the experimental group, increasing to 100% post-radiotherapy. The complete response (CR) rate was comparable between groups (90.0% vs. 86.7%, P\u00a0=\u00a01.000). With a median follow-up of 20.5 months, the 2-year progression-free survival (PFS) was significantly higher in the experimental group (82.5% vs. 66.0%; HR\u00a0=\u00a00.364, P\u00a0=\u00a00.0303), though overall survival (OS) did not differ significantly. The experimental group had a significantly lower incidence of radiotherapy-related intestinal toxicity (20% vs. 60%, P\u00a0=\u00a00.0033). All immune-related adverse events were grade 1-2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For high-risk LACC, NACI followed by RR was associated with a significantly lower incidence of radiotherapy-related intestinal toxicity. A potential PFS benefit was also observed, although its independent effect could not be confirmed in this limited sample. These findings warrant further investigation in larger prospective trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1784958","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:39:30Z","timestamp":1782106770000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Neoadjuvant chemotherapy and immunotherapy followed by radical radiotherapy for locally advanced cervical cancer: efficacy and safety"],"prefix":"10.3389","volume":"17","author":[{"given":"Qianxue","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yatong","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Jia","sequence":"additional","affiliation":[{"name":"Ultrasound Department, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuqin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Shengjing Hospital of China Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12749","article-title":"Revised FIGO staging for carcinoma of the cervix uteri","volume":"145","author":"Bhatla","year":"2019","journal-title":"Int J Gynaecol Obstet"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2013-0123","article-title":"Changes in prevalence and clinical characteristics of cervical cancer in the People's Republic of China: a study of 10,012 cases from a nationwide working group","volume":"18","author":"Li","year":"2013","journal-title":"Oncologist"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00147-X","article-title":"Adjuvant chemotherapy following chemoradiotherapy as primary treatment for locally advanced cervical cancer versus chemoradiotherapy alone (OUTBACK): an international, open-label, randomised, phase 3 trial","volume":"24","author":"Mileshkin","year":"2023","journal-title":"Lancet Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.5512","article-title":"Efficacy and safety of sintilimab plus paclitaxel and cisplatin as neoadjuvant therapy for locally advanced cervical cancer: A phase II trial","volume":"42","author":"Wan","year":"2024","journal-title":"J Clin Oncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/S1470-2045(23)00531-4","article-title":"Neoadjuvant chemotherapy plus camrelizumab for locally advanced cervical cancer (NACI study): a multicentre, single-arm, phase 2 trial","volume":"25","author":"Li","year":"2024","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-067767","article-title":"Neoadjuvant camrelizumab plus chemotherapy for locally advanced cervical cancer (NACI Study): a study protocol of a prospective, single-arm, phase II trial","volume":"13","author":"Chen","year":"2023","journal-title":"BMJ Open"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-024-00977-w","article-title":"Treatment advances across the cervical cancer spectrum","volume":"22","author":"Francoeur","year":"2025","journal-title":"Nat Rev Clin Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2018.04.019","article-title":"Neo-adjuvant platinum-based chemotherapy followed by chemoradiation and radical surgery in locally advanced cervical cancer (Lacc) patients: A phase II study","volume":"44","author":"Ferrandina","year":"2018","journal-title":"Eur J Surg Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904153401502","article-title":"Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer","volume":"340","author":"Rose","year":"1999","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23400","article-title":"Surgical versus radiographic determination of para-aortic lymph node metastases before chemoradiation for locally advanced cervical carcinoma: a Gynecologic Oncology Group Study","volume":"112","author":"Gold","year":"2008","journal-title":"Cancer"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2008.12.008","article-title":"Recent achievements and future developments in advanced and recurrent cervical cancer: trials of the Gynecologic Oncology Group","volume":"36","author":"Tewari","year":"2009","journal-title":"Semin Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904153401501","article-title":"Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer","volume":"340","author":"Morris","year":"1999","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904153401503","article-title":"Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma","volume":"340","author":"Keys","year":"1999","journal-title":"N Engl J Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.5.1339","article-title":"Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study","volume":"17","author":"Whitney","year":"1999","journal-title":"J Clin Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00468-9","article-title":"Immunotherapy plus chemoradiotherapy in cervical cancer management","volume":"403","author":"Tewari","year":"2024","journal-title":"Lancet"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01438-7","article-title":"Induction chemotherapy followed by standard chemoradiotherapy versus standard chemoradiotherapy alone in patients with locally advanced cervical cancer (GCIG INTERLACE): an international, multicentre, randomised phase 3 trial","volume":"404","author":"McCormack","year":"2024","journal-title":"Lancet"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01808-7","article-title":"Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11\/GOG-3047\/KEYNOTE-A18): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"404","author":"Lorusso","year":"2024","journal-title":"Lancet"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.230","article-title":"A phase II study of weekly neoadjuvant chemotherapy followed by radical chemoradiation for locally advanced cervical cancer","volume":"108","author":"McCormack","year":"2013","journal-title":"Br J Cancer"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35749","article-title":"Pembrolizumab with chemoradiotherapy followed by pembrolizumab for stage III-IVa cervical cancer: is the ENGOT-cx11\/GOG-3047\/KEYNOTE-A18 trial practice changing","volume":"131","author":"Penninx","year":"2025","journal-title":"Cancer"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2024.07.680","article-title":"Regarding \"Immunotherapy in locally advanced cervix cancer: A critical appraisal of the FDA indication based on ENGOT-CX11\/GOG-3047\/KEYNOTE-A18","volume":"189","author":"da Costa","year":"2024","journal-title":"Gynecol Oncol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.ygyno.2025.06.003","article-title":"Patient-reported outcomes from the phase 3, randomized, double-blind, placebo-controlled ENGOT-cx11\/GOG-3047\/KEYNOTE-A18 study of pembrolizumab plus concurrent chemoradiotherapy in participants with high-risk locally advanced cervical cancer","volume":"199","author":"Randall","year":"2025","journal-title":"Gynecol Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.70648","article-title":"Immune checkpoint therapy in locally advanced, persistent, recurrent, and metastatic cervical cancer: A systematic review and Bayesian network meta-analysis","volume":"173","author":"Hinojosa-Gonzalez","year":"2026","journal-title":"Int J Gynaecol Obstet"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2023.06.472","article-title":"Evolution of peripheral and tumor immune parameters as biomarkers of differential sequencing of immune checkpoint blockade and chemoradiotherapy in locally advanced cervical cancer: An NRG Oncology\/GOG Study","volume":"176","author":"Zamarin","year":"2023"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2025.102959","article-title":"Induction chemotherapy followed by chemoradiotherapy for locally advanced cervical cancer: A systematic review and meta-analysis","volume":"138","author":"Andrade","year":"2025","journal-title":"Cancer Treat Rev"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005853","article-title":"Efficacy and toxicity of different concurrent chemoradiotherapy regimens in the treatment of advanced cervical cancer: A network meta-analysis","volume":"96","author":"Fu","year":"2017","journal-title":"Med (Baltimore)"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1177\/17588359241312501","article-title":"Navigating the landscape of neoadjuvant immunotherapy for NSCLC: progress and controversies","volume":"17","author":"Chen","year":"2025","journal-title":"Ther Adv Med Oncol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa216","article-title":"Neoadjuvant immunotherapy for high-risk, resectable Malignancies: scientific rationale and clinical challenges","volume":"113","author":"Krishnamoorthy","year":"2021","journal-title":"J Natl Cancer Inst"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2015.00064","article-title":"Image-guided radiotherapy and -brachytherapy for cervical cancer","volume":"5","author":"Dutta","year":"2015","journal-title":"Front Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2223-4683.2014.04.01","article-title":"Urinary adverse effects of pelvic radiotherapy","volume":"3","author":"Liberman","year":"2014","journal-title":"Transl Androl Urol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3305\/nh.2015.32.5.9562","article-title":"Chronic enteritis in patients undergoing pelvic radiotherapy: prevalence, risk factors and associated complications","volume":"32","author":"Hernandez-Moreno","year":"2015","journal-title":"Nutr Hosp"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1177\/1533034616685942","article-title":"Changes in tumor volumes and spatial locations relative to normal tissues during cervical cancer radiotherapy assessed by cone beam computed tomography","volume":"16","author":"Chen","year":"2017","journal-title":"Technol Cancer Res Treat"},{"key":"B34","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1186\/s12885-017-3503-2","article-title":"Outcome and toxicity of radical radiotherapy or concurrent chemoradiotherapy for elderly cervical cancer women","volume":"17","author":"Wang","year":"2017","journal-title":"BMC Cancer"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1515\/med-2020-0222","article-title":"Acute chemoradiotherapy toxicity in cervical cancer patients","volume":"15","author":"Radojevic","year":"2020","journal-title":"Open Med (Wars)"},{"key":"B36","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/s0360-3016(01)01808-9","article-title":"Method and timing of tumor volume measurement for outcome prediction in cervical cancer using magnetic resonance imaging","volume":"52","author":"Mayr","year":"2002","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1784958\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:39:32Z","timestamp":1782106772000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1784958\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":36,"alternative-id":["10.3389\/fimmu.2026.1784958"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1784958","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"article-number":"1784958"}}