Neoadjuvant chemotherapy (Cisplatin/Ifosfamid) and radical hysterectomy versus primary radical hysterectomy in patients with locally advanced IB2 squamous cell cervical cancer
Abstract
Bulky IB2 squamous cell cervical cancer is becoming an important issue. Optimum treatment modality for this tumor is subject to many controversies today.
We examined the efficiency and safety of neoadjuvant high dose density chemotherapy (cisplatin 75mg/m2, ifosfamid 1,75mg/ m2) followed by radical hysterectomy. 22 women received 3 cycles of chemotherapy in 10 - 12 days intervals. There was no significant toxicity WHO grade III or IV.
Following the chemotherapy there was average volume tumor reduction of 71,2% detected by control MRI. One patient have stage IIB, final histology examination (21 patients) detected no residual disease in two (9,5%), less than 15 mm in largest diameter in 11 (52,3%) cases and less than 30 mm in 8 cases (38,1%).
Metastatic disease in pelvic nodes was detected in 23,8% of cases in NAC group versus 54% in primary surgery group (significant difference).