Neoadjuvant chemotherapy and adjuvant chemotherapy in radiotherapy for locally advanced cervical carcinoma IIIb

Fifty-eight untreated patients with locally advanced cervical carcinoma (International Federation of Gynecology and Obstetrics [FIGO] Stage IIIb) were enrolled in this study to evaluate the efficacy of a neoadjuvant chemotherapy consisting of 3 cycles of cisplatin, adriamycin, mitomycin and pepleomycin. A radiotherapy alone group (RT group) consisted of 45 patients, a neoadjuvant chemotherapy followed by second-line radiotherapy group (CR group) consisted of 8 patients and a first-line radiotherapy followed by second-line chemotherapy group (CR group) consisted of 5 patients. Twenty-five percent of the CR group achieved a complete tumor response (CTR) and 75% of the CR group achieved a partial tumor response (PTR). In the RC group, 87.5% of the patients achieved a CTR and 12.5% of the patients achieved a PTR. Three- and five-year survival rates were 71.1% and 62.2% in the RT group, 100% and 100% in the CR group, and 60% and 20% in the RC group (p<0.05), respectively. The incidence of complications by radiotherapy was 37.7% in the RT group and 15.4% in the combination group (CR and RC group). Our results suggest that neoadjuvant chemotherapy followed by radiotherapy is most effective for the treatment of cervical carcinoma IIIb as compared with radiotherapy alone or with first-line radiotherapy followed by second-line chemotherapy. (author)