The therapeutic value of preoperative neoadjuvent chemotherapy in patients with stage Ⅰ_(B2)~Ⅱ_b bulky cervical cancer / 中国癌症杂志

ABSTRACT

Background and Purpose:Cervical cancer is one of the most common malignant neoplasms among women.The 5-year survival for patients with early stage disease is over 70%.While it is generally accepted that either radical surgery or radiotherapy can achieve cure for the majority of patients with early-stage cervical cancer,there is no standard approach to the patients with bulky disease,whose prognosis remains very poor in spite of the therapeutic advances achieved in recent years.Neoadjuvant chemotherapy has been used as part of the multidisciplinary treatment before either operation or radiation therapy.Although the approach still had many controversies,numerous studies have supported its effectiveness in bulky cervical cancer.The present study was conducted to explore whether neoadjuvant chemotherapy with the combination of vincristine,bleomycin and cisplatin could improve the operability and pathological response rate in Ⅰb_(2)~Ⅱb bulky cervical cancer patients.Methods:A total of fifty-six patients with bulky cervical cancer were histologically diagnosed and staged into Ⅰb_(2)~Ⅱb according to the standards of International Federation of Gynecology and Obstetrics(FIGO) and randomly selected,including 15 cases with Ⅰb_(2),15 with Ⅱa,26 with Ⅱb.They were treated by a regimen of PVB chemotherapy for 2 cycles and followed by operation.The immediate response and adverse effects were analyzed.Results:The overall response rate was 78.6%.The resectability rate for surgery after chemotherapy was 100%.No intolerable toxic and adverse effects were recorded during neoadjuvant chemotherapy.Preoperative neoadjuvant chemotherapy can apparently increase the possibility of resection by operation and enhance the remission rate.The primary tumor sizes were significantly decreased after chemotherapy before surgery(P