Neoadjuvant paclitaxel and cisplatin in uterine cervical cancer: long-term results.
OBJECTIVE
To assess the effect of neoadjuvant chemotherapy with paclitaxel and cisplatin on long-term (5-year) survival of patients with stage IB2 to IIB cervical cancer.


METHODS
Forty-three consecutive patients with International Federation of Gynecology and Obstetrics stage IB2 to IIB uterine cervical cancer were treated with intravenous paclitaxel (60 mg/m), followed by intravenous cisplatin (60 mg/m) every 10 days. Two weeks after the third cycle of chemotherapy, the patients underwent surgery or radiation therapy, depending on overall condition. They were followed up, and 5-year survival rates and factors affecting prognosis were evaluated.


RESULTS
All of 43 patients underwent surgery. Of the 43 patients, 17 (39.5%) showed a complete response, 22 (51.2%) had a partial response to cisplatin-paclitaxel, making the overall response rate 90.7%; the remaining 4 patients (9.3%) had a stable disease. A down-staging response was seen in 72.1% (31/43) of patients showing a response. After surgery, patients received adjuvant therapy according to their pathological findings. Among the 43 patients, 37 were followed up. Kaplan-Meier analysis showed that the overall 2- and 5-year survival rates were 94.5% and 89.2%, respectively. Initial stage, response to neoadjuvant chemotherapy, differentiation, depth of invasion after chemotherapy, and metastasis were significantly correlated with survival. Differences in TA4, tumor size, and stage before and after chemotherapy were also significantly correlated with survival. In contrast, initial tumor size, carcinoembryonic antigen concentration, cell type, and lymphovascular invasion did not correlate significantly with survival rate.


CONCLUSIONS
Combination neoadjuvant chemotherapy with paclitaxel and cisplatin may improve long-term survival of patients with uterine cervical cancer.
Park
Dong Choon
DC
Department of Obstetrics and Gynecology, Saint Vincent's Hospital, Catholic University of Korea, Seoul, South Korea.
Suh
Min Jung
MJ
Yeo
Seung Geun
SG
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology
D017239:Paclitaxel; D002945:Cisplatin