3-YEAR RESULTS AFTER NEOADJUVANT CHEMOTHERAPY, RADICAL SURGERY, AND RADIOTHERAPY IN LOCALLY ADVANCED CERVICAL-CARCINOMA

Objective: To evaluate the complications and results of neoadjuvant tr eatment before surgery and radiotherapy in locally advanced cervical c arcinoma. Methods: Between March 1988 and June 1989, 24 consecutive pa tients with locally advanced cervical carcinoma received chemotherapy consisting of six weekly courses of cisplatin (50 mg/m2), Vincristine (1 mg/m2), and bleomycin (30 mg), followed by radical hysterectomy and radiotherapy. Lymph node metastases were detected by means of lymphan giography and confirmed by fine-needle aspiration in 21 patients. Resu lts: Twenty-one women (87.5%) completed the planned sequence of treatm ent and 16 (66.7%) achieved objective responses. Three patients did no t complete chemotherapy (one refusal, one myocardial infarction, one s evere allergic reaction) and were treated further by radiotherapy. Nin eteen subjects (79%) underwent subsequent radical surgery and radiothe rapy without serious complications. After a minimal follow-up of 3 yea rs, 16 patients had died of disease. Distant recurrences developed in only three of eight women in whom the nodes were negative originally, possibly reflecting systemic effectiveness of the chemotherapy. Conclu sion: This sequence of treatment, although feasible, does not seem to improve long-term survival compared to standard treatment.