[Evaluation of neoadjuvant chemotherapy for locally advanced cervical cancinoma].

OBJECTIVE: To investigate the effect of neoadjuvant chemotherapy on locally advanced cervical cancer, the factors affecting outcome of chemotherapy and the long-term survival rate in the patients.

METHODS: A total of 64 patients with stageIb2-IIb of locally advanced cervical cancers treated with neoadjuvant chemotherapy between June 1999 and October 2004 in Women's Hospital, School of Medicine, Zhejiang University were retrospectively analysed. The effect of chemotherapy, as well as survival rate was evaluated. The related factors of effect, including age, histology, clinical stage, grade of differentiation, initial tumor size, chemotherapy regimens, number of courses were analysed.

RESULTS: Overall effective rate of neoadjuvant chemotherapy was 80%. The effective rate was associated with histology. The patients with squamous cell cancer had significantly higher 5-year survival rate than those with adenocarcinoma (82% vs 6/9, P < 0.05). The rates of positive pelvic lymph node metastasis and parametrial invasion were significantly higher in complete or partial response patients than those in stable patients (P < 0.05). The overall 5-year survival rate was 89%. The 5-year survival rate in complete or partial response group was 100%, in stable disease group was 46% (P < 0.05). The 3, 5-year disease-free survival rate in complete or partial response group was 95% and 83%, respectively, while in stable disease group was 33% and 0, respectively. The disease-free survival rates in complete or partial response group were higher than those of stable disease group (P < 0.05).

CONCLUSIONS: The clinical response to neoadjuvant chemotherapy is related to histology. The patients who have good response to chemotherapy should choose surgery. Chemotherapy can decrease the high risk factors of pathology in complete or partial response patients. Neoadjuvant chemotherapy for locally advanced cervical cancer patients seems to improve the long-term survival rate.