[Neoadjuvant chemotherapy before radiotherapy in treatment of patients with cervical carcinoma]

To study the value of neoadjuvant chemotherapy in treatment of cervical carcinoma.

A clinical prospective study was carried out from Jan 1991 to Dec 2003. Totally 1609 patients with cervical carcinoma were given two cycles of combined chemotherapy before radiotherapy (neoadjuvant chemotherapy group, group A). Another 375 patients who accepted radiotherapy alone in our hospital from Jan 1989 to Dec 1990 were chosen as the control group (group B). Short-term control rate, long-term survival rate and complications were observed and analyzed.

In group A, after two cycles of neoadjuvant chemotherapy, the overall response rate was 74.5% (1199/1609), the complete response rate was 1.6% (25/1609). The survival rate of 3, 5 and 10-year was 90.3% (1017/1126), 75.3% (652/866), and 59.0% (200/339), respectively. Five-year survival rate in stage II was higher than that in stage III (P < 0.05), but 3-year and 10-year survival rate were not different between stages II and III (P > 0.05). In group B, 3, 5 and 10-year survival rate was 81.1% (304/375), 59.2% (222/375), and 40.3% (151/375), respectively. The 5-year and 10-year survival rate was significantly higher in stage II than that in stage III (P < 0.05). The 5 and 10-year survival rate was significantly higher in group A than that in group B (P < 0.05). The 3, 5 and 10-year survival rate of patients with adenocarcinoma in group A was obviously higher than that in group B (P < 0.05), and the 3 and 5-year recurrent and metastatic rate was significantly lower in group A than that in group B (P < 0.05). In group A, the short-term toxicity and side-effect of neoadjuvant chemotherapy were mainly slight and moderate, and the short-term and long-term radiation complications had no obvious difference between two groups (P > 0.05).

Neoadjuvant chemotherapy is a safe and effective method for the treatment of cervical carcinoma. Because of satisfactory short-term control rate and high long-term survival rate, neoadjuvant chemotherapy should be popularized in clinical treatment, especially in those patients with adenocarcinoma and in patients at clinically advanced stage of cervical carcinoma.