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KMID : 0616620090150020019
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Journal of Soonchunhyang Medical College
2009 Volume.15 No. 2 p.19 ~ p.30
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Neoadjuvant Chemotherapy Followed by Radical Surgery Versus Cisplatin-based Chemoradiation Therapy in Locally Advanced Cervical Carcinoma
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Jeon Seob
Kim Yun-Sook
Choi Seung-Do
Sunwoo Jae-Gun
Bae Dong-Han
Mun Seong-Taek
Song Eun-Seok
Kim Eun-Seog
Nam Kye-Hyun
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Abstract
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Background:To compare of toxicity and survival in two treatment groups ; neoadjuvant chemotherapy followed by radical surgery versus standard cisplatin based chemoradiation therapy in the treatment of locally advanced cervical cancers.
Methods:From 2004 to 2007, Among 31 patients with locally advanced cervical carcinoma stages IB2-lllB, 17 patients were treated with pelvic radiation plus 6 weekly course of cisplatin 40mg/m2 followed by brachytherapy (CCRT group) and 14 patients were treated with three 21 day course of neoadjuvant chemotherapy(paclitaxel 135 mg/m2 plus cisplatin 75 mg/m2) followed by radical hysterectomy (NACT group),
Results:In the CCRT group, complete remission occurred in 14 out of 17 patients, 3 patients recurred. Overall and disease free survival rates were 81.2% and 62.5% respectively, In the INACT group, overall clinical response rate to chemotherapy is 78.5% (CR, 50.0% PR 28.5%), pathologic response rate is 14,2%, and toxicity of chemotherapy was well tolerable. 3 patients recurred and overall and disease free survival rates were 92.8% and 71.4% respectively. At median follow up of 24 (range12-39) and 18 (range4-53)months in the CCRT and NACT groups respectively, there were no differences in overall survival and disease free survival rates.
Conclusions:The combination of paclitaxel and cisplatin seems to be tolerated and active in the locally advanced cervical cancer. The results of our comparison study suggest that neoadjuvant chemotherapy at feast as effective in terms of overall and disease free survival as standard cisplatin based chemoradiation therapy, Large sample of randomized study is needed to confirm these findings.
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KEYWORD
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Locally advanced cervical cancer, Concurrent chemoradiation, Weoadjuvant chemotherapy
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