Weekly cisplatin as neoadjuvant chemotherapy in locally advanced cervical cancer: a well-tolerated alternative

To assess the efficacy and the compliance of weekly cisplatin as neoadjuvant chemotherapy in locally advanced cervical cancer, 23 patients, FIGO stage IB-IIA > 4 cm-IIB, were recruited. Treatment consisted of four weekly courses of cisplatin (1.5 mg/kg): 91% of the patients received the planned therapy without dose reduction or delay. Toxicity was mild: delayed emesis was the most common side effect. Overall clinical response rate was 85% with a complete response in 28%. Nineteen patients underwent surgery without any undue increase in morbidity. Histologic analysis of surgical specimens revealed a complete response in 25% of stage IB-IIA patients; in only one case of stage IIB, was residual parametrial involvement present. In conclusion, weekly cisplatin is highly effective, with lower cost and less toxicity compared to other neoadjuvant chemotherapy regimens.