title: The efficacy and safety of neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer: A randomized multicenter study.
abstract: OBJECTIVE
  This study sought to evaluate the toxicity and curative effect of irinotecan plus cisplatin neoadjuvant chemotherapy (NACT) for stage Ib2, IIa2, and IIb cervical cancer patients.
  
  
  METHODS
  A total of 219 patients were randomly assigned to two groups: 109 patients were treated with 1-2 cycles of chemotherapy (NACT group), and 110 patients in the control group were treated directly with surgery (DS group). Patients in the NACT group were randomly assigned to two groups: 50 patients were treated with irinotecan plus cisplatin followed by surgery (IP group), and 59 patients were treated with paclitaxel plus cisplatin followed by surgery (TP group). Patients with pathological recurrence risk factors received post-operative radiotherapy.
  
  
  RESULTS
  Survival analysis revealed no significant difference in disease-free survival (DFS) or overall survival (OS) between the NACT and DS groups. Analysis of clinicopathologic factors showed that the lymphovascular space invasion (LVSI) and deep stromal invasion rates were significantly lower in the NACT group. Grade 3/4 neutropenia and grade 3/4 diarrhea were both higher in the IP group than in the TP group. DFS and OS were similar in the IP and TP groups. Univariate analysis showed that LVSI was the only factor associated with DFS.
  
  
  CONCLUSIONS
  NACT did not improve overall survival but did reduce the number of patients who received post-operative radiotherapy. NACT consisting of irinotecan plus cisplatin for cervical cancer showed similar efficacy and higher toxicity compared with the use of paclitaxel plus cisplatin, although the toxicity was tolerable.
authors.affiliation: Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71, Hedi Road, Nanning, Guangxi 530021, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71, Hedi Road, Nanning, Guangxi 530021, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, China.
authors.forename: Dandan
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71, Hedi Road, Nanning, Guangxi 530021, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, China.
authors.forename: Jieqing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71, Hedi Road, Nanning, Guangxi 530021, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, China.
authors.forename: Desheng
authors.initials: D
authors.lastname: Yao
authors.affiliation: Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71, Hedi Road, Nanning, Guangxi 530021, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Gao
authors.affiliation: Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71, Hedi Road, Nanning, Guangxi 530021, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, China.
authors.forename: He
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Gynecology, The Red Cross Hospital of Yulin, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Gynecology, 181st Hospital of Chinese People's Liberation Army, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Gynecologic Oncology, Affiliated Tumor Hospital of Guangxi Medical University, 71, Hedi Road, Nanning, Guangxi 530021, China; Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, China. Electronic address: lili_temp@hotmail.com.
authors.forename: Li
authors.initials: L
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007044:Hysterectomy; D000077146:Irinotecan; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000379:methods; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D055815:Young Adult
chemical_list: D000077146:Irinotecan; D017239:Paclitaxel; D002945:Cisplatin; D002166:Camptothecin
keywords: Cervical cancer; Cisplatin; Irinotecan; Neoadjuvant chemotherapy; Paclitaxel