Multimodal treatment for the locally advanced stage IB, IIA, IIB patients of cervical cancer.
By employing neoadjuvent chemotherapy (NCT) before radical hysterectomy (RS) and pelvic radiotherapy (RT) in bulky locally advanced cervical cancer (IB, IIA, IIB), the study was focused to update the results of the author's therapeutic experience with multimodal treatment by observing tumor free survivals along with related prognostic factors in different treatment modalities with NCT. The chemotherapy regimen for induction is composed of Vinblastin, Bleomycin and cis-Platin regimen (VBP). The effect of neoadjuvent chemotherapy was evaluated by the WHO definition of clinical response (CR, PR, ST, PG). As a result of NCT study in the stage IA, IIA, and IIB cervical cancer patients recurrence occurred in 50 out of 138 patients (35.5%) treated with radical hysterectomy only (RS) compared with 17 out of 92 patients (18.5%) treated with NCT followed by radical surgery. In conjunction with the NCT study in the cervical cancer, another two groups of patients who were treated by neoadjuvent chemotherapy followed by radical hysterectomy (NCST) and adjuvent radiation (NCSRT) were evaluated in the high-risk patients of cervical cancer with stage IB, IIA, and IIB. Primary responses in the NCST group (n = 61) were CR (68.9%), PR (22.9%), ST (4.9%) and PG (3.3%) respectively, while the chemoresponse of the NCSRT group (n = 101) were CR (65.3%), PR (18.9%), ST (4.9%) and PG (10.9%), respectively. The survival rates of the NCSRT group (n = 101) were 100% in all 1-5 years in CR group, while the rate of the NCST group was 100% at 1 year and 98.5% at 5 years in the CR group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Kim
S J
SJ
Department of Ob-Gyn, Kangnam St. Mary's Hospital, Catholic University Medical College Seoul, South Korea.
D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*