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Neoadjuvant Chemotherapy in Bulky Stage IB-IIA Cervical Cancer: Results of a Quick Course With Vincristine, Bleomycin, and Cisplatin
  1. Kyung-Do Ki, MD,
  2. Dong-Hwa Song, MD,
  3. Seo-Yun Tong, MD,
  4. Myong-Cheol Lim, MD,
  5. Jong-Min Lee, MD, PhD and
  6. Seon-Kyung Lee, MD
  1. Department of Obstetrics and Gynecology, East-West Neo Medical Center, Kyung Hee University, Seoul, Republic of Korea.
  1. Address correspondence and reprint requests to Jong-Min Lee, MD, PhD, Department of Obstetrics and Gynecology, East-West Neo Medical Center, Kyung Hee University, #149 Sangil-Dong, Gangdong-Gu, Seoul 134-727, Republic of Korea. E-mail: kgo02{at}hanmail.net.

Abstract

We retrospectively analyzed 51 consecutive patients with bulky International Federation of Gynecology and Obstetrics stage IB-IIA cervical cancer who were treated with vincristine (1 mg/m2), bleomycin (25 mg/m2; days 1-3), and cisplatin (50 mg/m2) every 10 days between 1995 and 2005 to assess the efficacy and the safety of a quick course of neoadjuvant chemotherapy. A clinical response occurred in 37 patients (72.5%), including 7 patients (13.7%) with a complete response and 30 patients (58.8%) with a partial response; 13 patients (25.5%) had a stable disease, and 1 patient (2.0%) had a progressive disease. Among the 50 patients who were surgically explored, 42 patients had a radical hysterectomy with pelvic and para-aortic lymphadenectomy; radical surgery was aborted in 8 patients because of paracervical and para-aortic lymph node involvement. Hematologic toxicity was the most common adverse event with anemia occurring most frequently, followed by leukopenia. Importantly, pulmonary toxicity occurred in 7 patients, 2 of whom died of complications from pulmonary fibrosis 1 and 3 months after radical surgery. With a median follow-up of 53 months (range, 2-129 months), the estimated 2- and 5-year survival rates were 74.9% and 61.3%, respectively. In conclusion, the survival benefit of a quick course of neoadjuvant chemotherapy consisting of vincristine, bleomycin, and cisplatin may be uncertain despite the significant clinical response in bulky International Federation of Gynecology and Obstetrics stage IB2-IIA cervical cancer. Special care is required to monitor bleomycin-induced pulmonary toxicity.

  • Carcinoma
  • Cervix
  • Chemotherapy
  • Neoadjuvant
  • Survival

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Footnotes

  • This study was supported by the Kyung Hee University Research Fund in 2007 (KHU-20071625).