Short-term Therapeutic Value Of Neoadjuvant Chemotherapy On Cervical Cancer.

Cervical cancer is one of the most common gynecological manlignancy in women worldwide, the incidence of disease is the first place in some developing countries. Although surgery and radiation are the conventional treatment methods for cervical cancer, the effect of the treatment did not improve in the past 40 years, the overall 5-year survival is about 50%.New cases that is found every year in our country is almost equivalently one third of all over the world. In recent years, bulky and locally advanced cervical cancer has a increasing tendency, and the age of those patients became more and more young during the last 20 years.After Feri firstly defined the neoadjuvant chemotherapy in 1982, NACT received increasing reconstruction by aboard and domestic scholars, and its therapeutic effect is confirmed gradually.we collect 30 patients with cervical cancer in stage Ib2-â…¡a, Another 60 patients at the same stages of cervical carcinoma who had not undergone NACT were recruited as control, and explore the Short-term therapeutic effect of NACT in cervical cancer.Objective:To evaluate the Short-term therapeutic value of neoadjuvant chemotherapy for cervical cancerMethods:We retrospective study the 90 patients with cervical cancer in stage Ib2-IIa who were admitted in the Dalian Maternal and Child Health Hospital from Aug.2007 to Jan.2010. All the patients had the integrated clinical and pathological data. The study group is NACT+S (30, in stage Ib2-â…¡a), as the control group with alone surgery (60, in stage Ib2-â…¡a). All of these 30 patients didn't have the contraindica30k proteinion for NACT, and they were all given an Extensive hysterectomy and Pelvic lymph node operation after 2-4 weeks on the end of the one or two cycles NACT. 60 patients as control group were directly treated with radical surgery.The tumor size and the side effects of the NACT were reviewed. Lymph node metastasis,the rates of deep stromal invasion, parametrial involvement, tumor positive rate of the incisal margin and the rate of lymphatic vascular space invasion were assessed after operation between the two groups. And we also compared the operative quality relating factors among the two group.Results:The response rate to NACT is satisfying (CR+PR=70%);The Short-term effect of NACT is confirmed; The overall clinical response rate was 93.33% and included a complete response (CR) in two patients (6.67%), partial response (PR) in nineteen patients (63.33%), and stable disease (SD) in seven patients (23.33%).Surgery revealed positive nodes in 35.0% primary surgery group patients and in 13.33% neoadjuvant chemotherapy group patients (p<0.05). Similar results occurred with vascular space involvement:43.33% in the primary surgery group compared to 20.0% in the neoadjuvant chemotherapy group (p<0.05). However, the rates of deep stromal invasion was found in 41.67% of the patients in the primary surgery group, while 46.67% showed in the neoadjuvant chemotherapy group(p>0.05). significant difference were not observed in tumor positive rate of the incisal margin and parametrial involvement.As far as factors related to surgery quality are concerned, the neoadjuvant chemotherapy group is superior to the primary surgery group, including the time of surgery and the blood loss during operation.And there is no severe side effect resulted from NACT.CONCLUSIONS:cervical cancer patients inâ… b2-â…¡a has good response rate to NACT, The downstaging effect and benefit on surgery quality were confirmed. Neoadjuvant chemotherapy can effectively eliminate the pathological risk factors.