title: [Stage IB2, IIA and IIB cervical carcinoma without lymph node extension treated with neoadjuvant chemoradiotherapy].
abstract: OBJECTIVE
  To evaluate the results of preoperative chemoradiation for resectable bulky cervical carcinoma without lymph node involvement after surgical lymph node staging.
  
  
  METHODS
  Between 2000 and 2010, 45 patients with cervical carcinoma stage IB2 (11 patients), IIA2 (3 patients) and IIB with proximal parametrial invasion (31 patients) were treated with pelvic radiation therapy at a dose of 40.5Gy and concurrent platin (44 patients) or mitomycin (one patient). Forty-two patients had low-dose-rate preoperative uterovaginal brachytherapy at a dose of 20Gy. All patients underwent hysterectomy. Three patients had postoperative low-dose-rate vaginal brachytherapy at a dose of 20Gy. The median follow-up was 34 months.
  
  
  RESULTS
  A pathologic cervical residual tumor was observed in 16 patients (35.6%). Six patients presented a relapse (13.3%) with a median delay of 8 months. The 5-year overall survival and disease free survival rates were 88.4% and 84.7%, respectively. In univariable analysis, a cervical residual tumor was the only predictive factor of overall survival (P=0.03). Late toxicity was observed in seven patients.
  
  
  CONCLUSIONS
  Chemoradiation followed by surgery for resectable bulky stage I-II cervical carcinoma without lymph node involvement on pretreatment surgical staging can be used with a good local control and a high rate of 5-year overall survival.
authors.affiliation: Hôpitaux universitaires Est parisien, hôpital Tenon, service d'oncologie-radiothérapie, 4, rue de la Chine, 75020 Paris, France; Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, 91-105, boulevard de l'Hôpital, 75634 Paris, France. Electronic address: laurie.monnier@tnn.aphp.fr.
authors.forename: Laurie
authors.initials: L
authors.lastname: Monnier
authors.affiliation: Hôpitaux universitaires Est parisien, hôpital Tenon, service d'oncologie-radiothérapie, 4, rue de la Chine, 75020 Paris, France; Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, 91-105, boulevard de l'Hôpital, 75634 Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Touboul
authors.affiliation: Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, 91-105, boulevard de l'Hôpital, 75634 Paris, France; Hôpitaux universitaires Est parisien, hôpital Tenon, service de gynécologie-obstétrique, 4, rue de la Chine, 75020 Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
authors.affiliation: Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, 91-105, boulevard de l'Hôpital, 75634 Paris, France; Groupe hospitalier La Pitié-Salpêtrière-Charles-Foix, hôpital La Pitié-Salpêtrière, service de chirurgie gynécologique et mammaire, 47, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Lefranc
authors.affiliation: Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, 91-105, boulevard de l'Hôpital, 75634 Paris, France; Groupe hospitalier La Pitié-Salpêtrière-Charles-Foix, hôpital La Pitié-Salpêtrière, service de chirurgie gynécologique et mammaire, 47, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: Betty
authors.initials: B
authors.lastname: Lauratet
authors.affiliation: Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, 91-105, boulevard de l'Hôpital, 75634 Paris, France; Hôpitaux universitaires Est parisien, hôpital Tenon, service de gynécologie-obstétrique, 4, rue de la Chine, 75020 Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Hôpitaux universitaires Est parisien, hôpital Tenon, service d'oncologie-radiothérapie, 4, rue de la Chine, 75020 Paris, France; Université Paris VI, faculté de médecine Pierre-et-Marie-Curie, 91-105, boulevard de l'Hôpital, 75634 Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Huguet
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D018365:Neoplasm, Residual; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D016685:Mitomycin; D002945:Cisplatin; D005472:Fluorouracil
keywords: Brachytherapy; Bulky cervical carcinoma; Cancer du col utérin de gros volume; Chimioradiothérapie préopératoire; Curiethérapie; Hysterectomy; Hystérectomie; Preoperative chemoradiotherapy