radiochimiotherapie concomitante preoperatoire dans le cancer du col uterin: resultats preliminaires

ABSTRACT

This is a retrospective study of patients treated for cancer cervix staged IB2, IIA or lIB with bulky tumor [>4cm]. Treatment was concurrent radiotherapy [45Gy with I,8Gy daily fraction] and chemotherapy [5 cycles of Platinum 40mg/m2/week]. All patients. underwent Brachytherapy [l5Gy on the reference isodose according to Paris system] followed by surgery [radical abdominal hysterectomy and bilateral pelvic lymphadenectomy Piver 3]. Between October 1999 and December 2002, forty five patients were treated in this protocol. Median age was 46 years [21- 68]. Histology was squamous cell carcinoma in 93% and glandular carcinoma in 7%. Average external radiation dose was 44Gy [20-50]. Ninety three% of patients had at least 3 cycles of chemotherapy and 46,5% received the planned 5 cycles. On the operative specimens, there was 62,5% complete response and only 7 pelvic node involvement [17,5%]. Four postoperative complications were noted [one vascular injury, one urinary fistula, one phlebitis and one lymph collection]. Preoperative combined radiotherapy and chemotherapy in the early bulky stages of uterine cervix cancer is well tolerated and "gives" a high rate of sterilisation. There was no increase in surgical morbidity