Survival Benefits of Neoadjuvant Chemotherapy Followed by Radical Surgery versus Radiotherapy in Locally Advanced Chemoresistant Cervical Cancer.
10.3346/jkms.2006.21.4.683
- Author:
Youn Seok CHOI
1
;
Jeong Im SIN
;
Ju Hyun KIM
;
Gi Won YE
;
Im Hee SHIN
;
Tae Sung LEE
Author Information
1. Department of Obstetrics and Gynecology, Catholic University of Daegu, Daegu, Korea. drcys@cu.ac.kr
- Publication Type:Original Article ; Comparative Study
- Keywords:
Neoadjuvant Therapy;
Hysterectomy, Radiotherapy;
Uterine Cervical Neoplasms
- MeSH:
Uterine Cervical Neoplasms/drug therapy/*radiotherapy/*surgery;
Treatment Outcome;
Survival Analysis;
Retrospective Studies;
Prognosis;
Neoplasm Staging;
Multivariate Analysis;
Middle Aged;
Humans;
Follow-Up Studies;
Fluorouracil/administration & dosage;
Female;
Drug Resistance, Neoplasm;
Combined Modality Therapy;
Cisplatin/administration & dosage;
Chemotherapy, Adjuvant;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use;
Adult
- From:Journal of Korean Medical Science
2006;21(4):683-689
- CountryRepublic of Korea
- Language:English
-
Abstract:
The aim of this study was to analyze long-term survivals in patients with stage IB to IIA cervical cancer treated by neoadjuvant chemotherapy setting. Between February 1989 and January 1998, 94 women with previously untreated stage IB to IIA carcinoma of the uterine cervix who received cisplatin based neoadjuvant chemotherapy were enrolled in this study. All of patients with chemoresponse (complete response, n=15; partial response, n=47) and 16 patients with chemoresistance received radical surgery (RS group). The other 16 patients with chemoresistance received radiotherapy for definite treatment (RT group). In the RS group, the 10 yr survival estimation in patients with bulky tumors (diameter > or =4 cm, n=26) was similar to that with non-bulky tumors (83.3% vs. 89.3%, p=NS). In selected patients with chemoresistance, those treated by radiotherapy (n=16) showed significantly poorer survivals than those treated by radical surgery (n=16) [10 yr survival rates of RT (25%) vs. RS (76.4%), p=0.0111]. Our results support that a possible therapeutic benefit of neoadjuvant chemotherapy plus radical surgery is only in patients with bulky stage IB to IIA cervical cancer. In cases of chemoresistance, radical surgery might be a better definite treatment option.
