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Cisplatin and vinorelbine as neoadjuvant chemotherapy in locally advanced cervical cancer: A Phase II study
  1. G. DI VAGNO*,
  2. G. CORMIO*,
  3. S. PIGNATA,
  4. G. SCAMBIA§,
  5. M.G. DI STEFANO§,
  6. R. TAMBARO,
  7. P. TREROTOLI,
  8. G. SERIO,
  9. G. GARGANESE* and
  10. L. SELVAGGI*
  1. * Department of Obstetrics and Gynecology, University of Bari, Roma; Italy
  2. †Department of Statistics, University of Bari, Roma; Italy
  3. ‡Department of Medical Oncology B, National Cancer Institute, Napoli, Italy
  4. §Department of Obstetrics and Gynecology, University of Sacred Heart, Roma; Italy
  1. Address correspondence and reprint requests to: Giovanni di Vagno, MD, Clinica Ostetrica e Ginecologica II – University of Bari., Piazza G. Cesare 11, 70124 Bari, ITALY. Email: g.divagno{at}gynecology2.uniba.it.

Abstract

Fifty eight consecutive untreated patients with locally advanced cervical carcinoma (LACC) received neoadjuvant chemotherapy (NACT) with cisplatin (CDDP) 80 mg/sqm (day 1) + vinorelbine (VRL) 25 mg/sqm (day 1 and 8). Three cycles of chemotherapy were planned every 21 days. Within 28 days from the completion of chemotherapy patients in complete or partial response were submitted to radical hysterectomy with pelvic lymphadenectomy. On 155 cycles, hematologic toxicity was mild (G3-4 neutropenia and anemia occurred in 16% and 5%, respectively). Forty-seven patients (81%) were submitted to radical surgery; eight (14%) patients were deemed ineligible for surgery because of poor response to treatment, two (3%) for anesthesia contraindications and one (2%) refused surgery. At pathologic examination 12 patients (25%) had a complete response, one (2%) in-situ carcinoma, six (13%) residual microinvasive disease, and 28 (60%) a partial response. None had extracervical disease. Eight patients (14%) had microscopic lymph node metastases. The number of cycles administered was sigificantly associated with a good pathologic response. Association of CDDP and VRL as NACT in LACC appears safe and effective. Low cost and modest toxicity would support the initiation of a multicenter randomized phase III trial to compare this association with cisplatin alone.

  • cervical carcinoma
  • cisplatin
  • neoadjuvant chemotherapy
  • vinorelbine

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