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To evaluate the therapeutic potential of cytotoxic therapy in patients with cervical cancer, 57 previously untreated patients with bulky mass (more than 3 cm) in stage Ib, IIa, and IIb locally advanced cervical cancer were treated with three courses of induction chemotherapy of Cisplatin and 5-FU combined regimen and placed on subsequent radical surgery or radiation therapy during Jan. 1, 1988 to April 31, 1990. The results were obtained as follows. 1. As to the response rates, complete response was seen in 22 cases (38.6%), and partial response in 30 cases (52.6%), so the total response rate was 91.8%. 2. The rewponse rates seemed to increase in the lower clinical stage than the higher and the smaller size of the lesion than the bigger. 3. Thirteen cases of the 48 surgical specimens (27.1%) were found to be histologically free of disease. 4. The overall incidence of surgically documented nodal metastasis was found to be 29.1% and higher incidence was found in advanced clinical stage and poor responders. 5. Patients achieving complete response (CR) to induction chemotherapy with subsequent radical surgery had much more improved mean 2 year disease free survival rate compared with those who had radiation therapy after CR. 6. Toxicities encountered during chemotherapy were nausea and vomiting, alopecia, bone marrow depression, hepatotoxicity, nephrotoxicity, etc. and well tolerated in most of cases except one case of death due to severe bone marrow depression and septicemia. Conclusively, this preliminary study suggests that Cisplstin and 5-FU combination, followed by radical surgery is one of the most effective and beneficial treatment methods in the management of some patients who are at high risk for failure with conventional treatment. It is still necessary to take well designed prospective long term study with longer follow-up to define which modality of treatment could positively influence prolonged disease free survival.
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