title: Efficacy and tolerability of paclitaxel, ifosfamide, and cisplatin as a neoadjuvant chemotherapy in locally advanced cervical carcinoma.
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of a neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy in patients with locally advanced cervical carcinoma.
  
  
  METHODS
  Patients with histologically confirmed locally advanced cervical carcinoma, aged ≥18 years, were treated with intravenous ifosfamide 5,000 mg/m² and mesna 5,000 mg/m², on day 1; intravenous paclitaxel 175 mg/m² and cisplatin 75 mg/m², on day 2; every 3 weeks for three cycles. Following chemotherapy, operable patients underwent radical hysterectomy and pelvic lymphadenectomy, and, if necessary, adjuvant radiotherapy.
  
  
  RESULTS
  One hundred fifty-two patients with median age 53 years (range, 24 to 79 years), FIGO stage IIB in 126 (89%), were treated with chemotherapy for median 3 cycles (range, 1 to 3). Treatment was delayed or withdrawn in 23 patients (15%). One hundred thirty-nine patients (91%) underwent surgery. Postchemotherapy pathological complete response rate was 18% (25 patients). Postoperative radiotherapy was administered in 100 patients (72%). The 5-year overall survival and progression-free survival were 87.3% (95% confidence interval [CI], 84.5 to 90.3) and 76.4% (95% CI, 73.5 to 79.5), respectively.
  
  
  CONCLUSIONS
  Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy was feasible and effective in the treatment of locally advanced cervical carcinoma patients with older age and more advanced disease stage than reported in previous studies. Hematological and renal toxicity could be carefully prevented.
authors: Division of Gynecological and Medical Oncology, Department of Maternal and Child, Cannizzaro Hospital, Catania, Italy. giusy.scandurra@gmail.com.
authors: Giuseppa
authors: G
authors: Scandurra
authors: Division of Gynecological and Medical Oncology, Department of Maternal and Child, Cannizzaro Hospital, Catania, Italy.
authors: Giuseppe
authors: G
authors: Scibilia
authors: Division of Gynecological and Medical Oncology, Department of Maternal and Child, Cannizzaro Hospital, Catania, Italy.
authors: Giuseppe Luigi
authors: GL
authors: Banna
authors: Division of Gynecological and Medical Oncology, Department of Maternal and Child, Cannizzaro Hospital, Catania, Italy.
authors: Gabriella
authors: G
authors: D'Agate
authors: Division of Gynecological and Medical Oncology, Department of Maternal and Child, Cannizzaro Hospital, Catania, Italy.
authors: Helga
authors: H
authors: Lipari
authors: IBFM-CNR, Cefalù, Italy.
authors: Stefania
authors: S
authors: Gieri
authors: Division of Gynecological and Medical Oncology, Department of Maternal and Child, Cannizzaro Hospital, Catania, Italy.
authors: Paolo
authors: P
authors: Scollo
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D055815:Young Adult
chemical_list: D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide
keywords: Antineoplastic Combined Chemotherapy Protocols; Disease-Free Survival; Retrospective Studies; Uterine Cervical Neoplasms