Long-term results of sequential chemotherapy-radiotherapy-chemotherapy in locally advanced squamous cell carcinoma of the uterine cervix

Purpose of investigation. In order to evaluate the impact of sequential che motherapy-radiotherapy-chemotherapy on local control and survival, a follow -up study was carried out 12 years after the treatment of 22 patients with FIGO stage IIB-III squamous cell cervical cancer. Methods. Patients were submitted to three cycles of induction chemotherapy (cisplatin and bleomycin) followed by whole pelvis irradiation and central boost with endocavitary brachytherapy. Ten patients underwent three further cycles of chemotherapy after radiotherapy. All patients were maintained by regular follow-up. Only one patient was lost 48 months after treatment. Results. At the end of treatment complete response was obtained in 14 patie nts (63.5%). Four of these recurred locally, and one at also distance. Eigh t patients failed to obtain a complete response. Twelve patients died from disease and one patient died from other causes. Nine of 22 (41%) patients a re alive without evidence of disease with a median follow-up of 134 months. Acute toxicity was mild, while two severe late complications were observed . Conclusions. The achievement of complete remission at the end of treatment is important in tcr ms of life expectancy. Further chemotherapy appears use ful for patients who do not reach complete local remission after radiothera py.