Radical surgery after neoadjuvant intra-arterial chemotherapy in stage IIIb squamous cell carcinoma of the cervix

We examined the efficacy and safety of neoadjuvant intra-arterial chemother apy (NAC) followed by radical hysterectomy and/or radiotherapy in patients with stage IIIb cervical cancer. Treatment consisted of bilateral internal iliac artery infusion of cisplatin or carboplatin and peplomycin every 21 d ays for two courses. Patients who responded to NAC underwent radical surger y. Patients who Rid not respond to NAC were treated with pelvic radiotherap y. Complete response was achieved in 2 (7.1%) of 28 patients, while a parti al response was observed in 17 (60.7%) and stable disease in 9 (32.1%) pati ents. Sixteen patients (57.2%) were able to undergo surgery. The median blo od loss (674 mi) and operating time (232 min) for radical surgery in patien ts with stage IIIb disease was similar to that in patients with stages Ib t o IIb disease. No intra-operative or, immediate postoperative complications were observed. The S-year disease-free survival (DFS) for patients who und erwent surgery (81.3%) was higher than for patients who underwent radiother apy after NAC (31.3%). Radical surgery after NAC for stage IIIb disease was safe, and a survival benefit followed by surgery with or without radiother apy.