Objective: To evaluate clinical efficacy, toxicity, and survival outcomes of neoadjuvant chemotherapy (NACT) followed by radical surgery (RS) among patients with cervical cancer stage IB2-IIB.
Methods: In a retrospective clinical study at West China Second Hospital, Chengdu, data were analyzed from 414 patients who underwent NACT followed by radical surgery (NACT-RS) or RS alone between January 2008 and November 2009.
Results: The clinical response for NACT was 90%. Lymph node metastasis (25% versus 48%, P<0.05) and deep cervical stromal invasion more than 0.5, (68% versus 91%, P<0.05) were significantly lower among responders than among non-responders, respectively, in the NACT-RS group. The 2-year progression-free survival and 2-year overall survival were 93.0% and 95.5% in the NACT-RS group, and 94.5% and 97.1% in the RS group (P>0.05). Parametric infiltration (hazard ratio [HR], 7.668; P<0.05) and lymph node metastasis (HR, 7.714; P<0.05) were independent risk factors for all study patients.
Conclusion: Compared with RS, NACT-RS did not show a significant advantage for patients with locally advanced cervical cancer. However, the data provide the rationale for assessing NACT-RS in a multicenter randomized clinical trial setting. NACT may be considered as an alternative treatment when radiotherapy is not available.
Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.