531 Neoadjuvant Chemotherapy in Cervical Cancer Patients

Objective: The purpose of this study was to evaluate the efficacy and toxicity of neoadjuvant chemotherapy in cervical cancer patients. Material and methods: From 1992 to 2003, all consecutive women with cervical cancer receiving neoadjuvant chemotherapy were identified. Data for analysis were collected from hospital charts and office records. The toxicity of the regimen was determined according to the WHO toxicity criteria. The impact of clinical and pathologic risk factors on the survival of patients undergoing neoadjuvant chemotherapy was evaluated using Kaplan-Meier life table analyses and log-rank tests with p values less than 0.05 considered significant. Results: Sixty-seven patients undergoing neoadjuvant chemotherapy were collected, which included 34 with FIGO stage I, 28 with stage II, and 5 with stage IV disease. Clinical response to neoadjuvant chemotherapy occurred in 61 patients, including 6 with complete response and 55 with partial response; 5 women showed stable disease and 1 progressed. Hematologic toxicity was seen in 14 patients with most of them consisting in anemia grade 3 or 4. Eighteen women had recurrence mostly in the vagina and pelvis. The 5-year survival rate and median survival were 63% and 93 months. in univariate analysis, response to neoadjuvant chemotherapy, treatment after neoadjuvant chemotherapy, miometrial invasion, and lymph nodes involvement were important prognostic factors. Conclusion: Neoadjuvant chemotherapy seems to be tolerated and very active in the treatment of cervical cancer. A prospective randomized trial with a larger number of cases is needed to confirm the efficacy of this treatment.