title: Neoadjuvant chemotherapy followed by extended-field concurrent chemoradiotherapy in squamous cell carcinoma of the cervix with positive paraaortic lymph nodes: two cases.
abstract: OBJECTIVE
  To report the feasibility of neoadjuvant chemotherapy (NAC) followed by extended-field concurrent chemoradiotherapy (EF-CCRT) for squamous cell carcinoma of the cervix (CC) with paraaortic lymph node (PAN) metastasis.
  
  
  METHODS
  Two patients were diagnosed with CC with positive PAN, and received two courses of cisplatin (120 mg/m2) in a neoadjuvant setting. They then received extended-field, external-beam radiotherapy (50.4 Gy) followed by intracavitary brachytherapy concurrently with cisplatin (20 mg/m2 x 5 days) at 21-day intervals.
  
  
  RESULTS
  EF-CCRT was interrupted in one patient for five days because of grade 4 neutropenia. No severe late toxicities were observed. The two patients are alive with no evidence of recurrence at present.
  
  
  CONCLUSIONS
  NAC followed by EF-CCRT is feasible and may improve the survival outcome of patients with CC with positive PAN.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan. h013916@med.u-ryukyu.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Hirakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Nagai
authors.forename: C
authors.initials: C
authors.lastname: Yagi
authors.forename: T
authors.initials: T
authors.lastname: Nashiro
authors.forename: M
authors.initials: M
authors.lastname: Inamine
authors.forename: Y
authors.initials: Y
authors.lastname: Aoki
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000187:drug effects*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy
chemical_list: D011838:Radiation-Sensitizing Agents; D002945:Cisplatin