Neoadjuvant gemcitabine and cisplatin followed by radical surgery in (bulky) squamous cell carcinoma of cervix stage IB2

Objectives. This study aimed to evaluate the efficacy and toxicity of gemeitabine in combination with cisplatin as neoadjuvant therapy in patients with cervical carcinoma stage IB2. Patients and methods. Chemotherapy-naive patients with histologic diagnosis o squamous cell cervical carcinoina staged as IB2 were treated with 2 cycles of cisplatin (70 mg/m(2) on day 1) and gemeitabine (1000 mg/m(2) on (lays 1 and 8), given every 21 days. After chemotherapy, patients underwent radical hysterectomy and pelvic lymphadenectomy. Patients judged to have a non-resectable disease were treated with standard pelvic radiation. Results. Between September 2000 to March 2004, 28 patients were enrolled in the study of which 27 were evaluable for efficacy and toxicity. The mean age was 39 years (30-55). The overall clinical response rate was 88.9%. (24 27), with complete response (CR) in 9/27 patients (33.3%) and partial response in 15/27 patients (55.5%). Three patients (11.1%) did not respond and nobody progressed. A pathological CR was noted in 2 of 24 patients who underwent radical surgery. The 3 non-responding patients were subsequently treated with radiation and achieved CR. Grades 3 or 4 neutropenia, anemia, or thrombocytopenia was observed in 7,4%, and 3.7% patients respectively. Non-hematological toxicity was mild except grade 3 nausea/vomiting in 18.5% patients. At median follow-tip time of 36,7 months (range 7-51 months), the 3-year survival was 88.9%. Conclusion. Neoadjuvant treatment with gemeitabine/cisplatin combination for patients with cervical cancer (stage 1132) appears encouraging, with manageable and acceptable toxicity profile, (c) 2005 Elsevier Inc. All rights reserved.