Pre-operative Neoadjuvant Chemotherapy Followed By Radical Surgery In The Treatment Of Cervical Carcinoma

OBJECTIVE: To investigate the effect of Neoadjuvant Chemotherapy (NACT) on cervical carcinoma.METHODS: Among 619 patients experienced radical surgery (radical hysterectomy + lymphadenectomy) for cervical carcinoma, 228 patients with diameter of local lesions > 4cm and stage (FIGO) from EB~IIIB were included in our study. Patients were divided into 3 groups according to different treatments: 1) NACT+S group (n=63): patients accepted NACT with Bleomycin and Cisplatin, 2) RT+S group (n=11): patients underwent primary radiotherapy, 2) S group (n=154): patients went to radical surgery directly. The response rate of tumor, downstaging effect, lymph node metastasis and tumor positive rate of the incisal margin were observed; And we also compared the operative quality relating factors and five-year survival rate among the three groups; The side effects of the NACT were reviewed, too.RESULTS: The response rate to NACT is satisfying (CR+PR=83%); The downstaging effect of NACT is confirmed (P<0.05); As far as factorsrelated to surgery quality are concerned, NACT+S group is superior to S group and RT+S group on the whole; And there is no severe side effect resulted from NACT; When come to five-year survival rate, there is no difference with statistical significance.CONCLUSIONS: Cervical carcinoma has good response rate to NACT, and the BLM+DDP NACT is safe when given the dose in our study. The downstaging effect and benefit on surgery quality were confirmed. But there is no enough evidence of NACT on the five-year survival rate for patient with cervical carcinoma.