ABSTRACT
Purpose:To evaluate the effect of preoperativ e chemotherapy or brachtherapy and radical hysterectomy on stage Ⅰb-Ⅱb locally advanced cervical cancer with high risk factors. Methods:preoperative chemotherapy or radiotherapy followed by r adical hysterectomy compared to radical hysterectomy alone in stage Ⅰb-Ⅱb cer vical cancer with higher risk factors(bulky,lower grade,small cell cancer or ade nocarcinoma). Results:①Pelvic lymphnode metastases rate was significantly decreased in the neoadjuvant chemotherapy arm compared with surgery alone(P 0.05). Conclusions:Preoperative chemotherapy followed by surgery is e ffective and superior to surgery alone in stage Ⅰb-Ⅱb cervical cancer with high risk factors.It might be able to reduce tumor volume and eliminate effectiv ely disease in lymphnodes and possibly micrometastases.It may be beneficial in improving quality of life of patients by decreasing the need for postoperative r adiotherapy. Response to chemotherapy may be a prognostic factor.Preoperative br achytherapy showed no significant advantage in eliminating lymphnodes matastases as compared to surgery alone.