title: Neoadjuvant chemotherapy followed by radical surgery in patients affected by FIGO stage IVA cervical cancer.
abstract: BACKGROUND
  Concomitant chemoradiotherapy represents the standard treatment for patients affected by locally advanced cervical cancer. Survival rates in patients affected by FIGO stage IVA disease remain poor. Some authors have suggested that neoadjuvant chemotherapy followed by radical surgery might be a valid alternative to standard treatment. The objective of this study was to analyze the feasibility and results obtained by neoadjuvant chemotherapy in patients affected by stage IVA disease.
  
  
  METHODS
  Eighteen patients affected by FIGO stage IVA cervical cancer were treated with 175 mg/m(2) paclitaxel and 75 mg/m(2) cisplatin every 21 days for three courses followed by radical surgery when feasible.
  
  
  RESULTS
  All patients were subjected to the three planned chemotherapy courses. Two patients achieved a complete clinical response, and 10 patients achieved a partial clinical response. Ten patients were subjected to anterior pelvic exenteration, whereas the remaining eight patients were treated with chemotherapy, radiotherapy, and concomitant chemoradiotherapy. The estimated 3-year and 5-year overall survival rates were 47.4% and 31.6%, respectively. Patients eligible for surgery benefited from significantly longer survival rates.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy followed by radical surgery is feasible in approximately half of patients affected by FIGO stage IVA cervical cancer. Overall survival rates appear similar to those reported with concomitant chemoradiotherapy. Patients who are amenable to radical surgery after chemotherapy may benefit from long-term survival rates.
authors.affiliation: Department of Obstetrics and Gynecology, University of Rome La Sapienza, Viale del Policlinico, 155, Rome, Italy. pierluigi.benedettipanici@uniroma1.it
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Benedetti Panici
authors.forename: Filippo
authors.initials: F
authors.lastname: Bellati
authors.forename: Natalina
authors.initials: N
authors.lastname: Manci
authors.forename: Milena
authors.initials: M
authors.lastname: Pernice
authors.forename: Francesco
authors.initials: F
authors.lastname: Plotti
authors.forename: Violante
authors.initials: V
authors.lastname: Di Donato
authors.forename: Marco
authors.initials: M
authors.lastname: Calcagno
authors.forename: Marzio Angelo
authors.initials: MA
authors.lastname: Zullo
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
chemical_list: D017239:Paclitaxel; D002945:Cisplatin