J Med Assoc Thai 2012; 95 (3):55

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The Efficacy of Neoadjuvant Paclitaxel-Carboplatin Chemotherapy Followed by Radical Hysterectomy Compared to Radical Hysterectomy alone in Bulky Stage IB2-IIA Cervical Cancer
Prueksaritanond N Mail, Chaisarn P , Yanaranop M

Objective: To compare the efficacy of neoadjuvant paclitaxel-carboplatin chemotherapy followed by radical hysterectomy with radical hysterectomy alone in patients with bulky cervical cancer stage IB2-IIA.
Material and Method: From January 2000 through December 2009, 80 patients with bulky cervical cancer stage IB2-IIA that received neoadjuvant paclitaxel-carboplatin chemotherapy (n = 40) or immediate primary surgery (n = 40) were reviewed. The efficacy of neoadjuvant chemotherapy on the basis of feasibility in operation and pathological prognostic factors and the percentage of patients who needed postoperative adjuvant concurrent chemoradiation therapy were compared.
Results: There were no significant differences between group in age, tumor size, FIGO staging, histologic type and grading at the time of diagnosis. All patients in neoadjuvant chemotherapy group successfully underwent radical hysterectomy. The pathological findings included tumor size, deep cervical invasion, parametrial involvement, positive surgical margin and lymphovascular space invasion were statistically significant decrease in neoadjuvant chemotherapy group. Nevertheless, the pelvic nodal metastasis was not different between both groups. Adjuvant concurrent chemoradiation therapy had a statistically significant decrease in the neoadjuvant chemotherapy group.
Conclusion: Neoadjuvant chemotherapy significant by improves the feasibility in operation and the pathological prognostic factors, and decreases the percentage of patients who needed postoperative adjuvant concurrent chemoradiation therapy.

Keywords: Bulky cervical cancer stage IB2-IIA, Neoadjuvant chemotherapy, Radical hysterectomy, Rajavithi Hospital


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