Preoperation concurrent radiation therapy and chemotherapy for operable bulky carcinomas of uterine cervix stagesⅠandⅡwith proximal parametrial invasion / 肿瘤研究与临床

ABSTRACT

Objective To investigate the feasibility and efficacy of combined preoperative chemora- diation program followed by radical surgery in bulky early or moderate uterine cervical cancer.To determine the incidence and predictive value of rasidual disease in the radical hysterectomy specimens after CCR. Methods Thirty-five patients with uterine cervix carcinoma from January 2001 to September 2003 were treated with preoperative external beam radiotherapy to 3060 cGy in 4 weeks.Patients received concurrent continuous infusion cisplatin(20 mg/m~2)on day 1,8,15,22 of four weeks and 5-Fu(4 g)chemotherapy during the first four days and the last four days of the radiation course.Radical surgery was not performed until 4 weeks after the completion of the preoperative treatment.Results Clinical response was 85.71%,complete response,54.29 %;partial response,31.43 %.The analysis of the surgical specimens showed 19 patients had revealed residual disease and 16 patients had revealed no residual disease,the complete pathological response hed been 45.71%.Three-year survival rate was 87.14 % in 35 patients.Three-year survival rate of residual disease patients(76.32 %)was significantly lower than that of no residual disease(100.0 %)(P=0.0358). Three-year survival of cervical stromal invasion less than 1/2 and invasion extra stromal was 100.0 %, 41.67 % respectively(P=0.0109);three-year survival of lymph-vascular space involvement and no lymph- vascula space involvement was 0,85.29 %,respectively(P=0.0148).Conclusion Combined preoperative chemoradiation program followed by radical surgery in bulky early or moderate cervical cancer could reveal an effective efficacy with a tolerant complication.Residual disease is an independent and strong predictive factor.