title: Neoadjuvant chemotherapy plus radical surgery followed by chemotherapy in locally advanced cervical cancer.
abstract: OBJECTIVE
  To evaluate the efficacy, in terms of safety, overall survival and progression free survival of neoadjuvant chemotherapy followed by radical surgery plus adjuvant chemotherapy in patients affected by locally advanced cervical cancer (stage IB2-IIB) with or without node metastases.
  
  
  METHODS
  Between June 2000 and February 2007, all patients with diagnosis of locally advanced cervical cancer referred to the Division of Gynecologic Oncology of the University Campus Bio-Medico of Rome were eligible for this protocol. All enrolled patients received 3 cycles of platinum-based chemotherapy every 3 weeks according to the scheme Cisplatin 100mg/mq and Paclitaxel 175 mg/mq. After neoadjuvant chemotherapy all patients with stable or progressive disease were excluded from the protocol, the others were submitted to classical radical hysterectomy, bilateral salpingo-oophorectomy and bilateral systematic pelvic lymphadenectomy and 4 cycles of adjuvant treatment with platinum based chemotherapy were executed.
  
  
  RESULTS
  Concerning intention to treat basis analysis, 5 year overall survival (OS) and disease-free survival (DFS) are 77% and 61%, respectively. The 5-year OS of patients with positive pelvic nodes and those with negative nodes metastases was respectively 60% and 87%. Concerning the according to protocol analysis, the 5-year OS and DFS are 81% and 70% respectively. The 5-year OS in patient with positive and negative lymph nodes is 75% and 88% respectively.
  
  
  CONCLUSIONS
  The adjuvant chemotherapy regimen after neoadjuvant chemotherapy and radical surgery represents a valid treatment for patients with locally advanced cervical cancer.
authors: Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy. r.angioli@unicampus.it
authors: Roberto
authors: R
authors: Angioli
authors: Francesco
authors: F
authors: Plotti
authors: Roberto
authors: R
authors: Montera
authors: Alessia
authors: A
authors: Aloisi
authors: Daniela
authors: D
authors: Luvero
authors: Stella
authors: S
authors: Capriglione
authors: Corrado
authors: C
authors: Terranova
authors: Carlo
authors: C
authors: De Cicco Nardone
authors: Ludovico
authors: L
authors: Muzii
authors: Pierluigi
authors: P
authors: Benedetti-Panici
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007044:Hysterectomy; D057194:Intention to Treat Analysis; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010052:Ovariectomy; D017239:Paclitaxel / Q000008:administration & dosage; D010388:Pelvis; D011446:Prospective Studies; D058994:Salpingectomy; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D017239:Paclitaxel; D002945:Cisplatin