- 作者：Lin Gong ; Jian-Yan Lou ; Ping Wang ; Jia-Wen Zhang ; Hui Liu ; Zhi-Lan Peng ; pengzhilan1@163.com
- 关键词：Locally advanced cervical cancer ; Neoadjuvant chemotherapy ; Radical surgery
- 刊名：International Journal of Gynecology and Obstetrics
- 出版年：2012
- 期刊代码：130_00207292
- 类别：med
- 出版时间：April, 2012
- 卷：117
- 期：1
- 页码：23-26
- 文件大小：207 K
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.