WEEKLY CISPLATIN INDUCTION CHEMOTHERAPY IN HIGH-RISK CERVICAL-CANCER PATIENTS WITH BULKY TUMOR - A PHASE-II STUDY

In this study we evaluated efficacy and toxicity of a neoadjuvant chem otherapy regimen before radiation therapy or surgery in high-risk cevi cal cancer patients. Between January 1988 and July 1993, 37 out of 40 consecutive patients with bulky cervical carcinoma (>40 mm) received c hemotherapy consisting of six (range 4-9) weekly courses of cisplatin (1 mg/kg), followed by radical surgery and/or radiotherapy. Thirty-six patients completed the planned sequence of treatment. Overall respons e rate was 65% after induction chemotherapy (complete 0% and partial 6 5%) and 73% (complete 57% and partial 16%) after definitive treatment. After a median follow-up of 23 (range 4-61) months the median duratio n of response was 29, 19 and 11 months for complete partial and non-re sponders respectively. Toxicities from induction chemotherapy were mil d to moderate, reversible and tolerable and did not affect the subsequ ent application of the definitive treatment. The proposed cisplatin ne oadjuvant chemotherapy regimen gave positive results in a good number of cases with low toxicity and without interfering with the definitive radio-surgical treatment of this group of high-risk patients. The num ber of cisplatin courses for best effect remains to be established.