Treatment of (“bulky”) stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: A phase III trial of the gynecologic oncology group

Eddy, Gary L.; Bundy, Brian N.; Creasman, William T.; Spirtos, Nick M.; Mannel, Robert S.; Hannigan, Edward V.; O’Connor, Dennis M.

doi:10.1016/j.ygyno.2007.04.007

Cited by 149 publications

(122 citation statements)

References 18 publications

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“…Compared to neoadjuvant chemotherapy, the pelvic recurrence within two years was statistically significantly lower in the concurrent chemoradiotherapy group, while the 5-year survival was not statistically significantly higher than the other groups, which agrees well with the findings that neoadjuvant chemotherapy achieves high short-term response but does not affect long-term survival much (Eddy et al, 2007).…”

supporting

confidence: 87%

Values of Three Different Preoperative Regimens in Comprehensive Treatment For Young Patients with Stage Ib2 Cervical Cancer

Zhao¹,

Wang²,

Chen³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Cervical cancer tends to occur at an early age. Treatment for cervical cancer includes surgery, chemotherapy, radiotherapy or their combination. The 2-year survival of early cervical cancer after surgery or chemoradiothearpy reaches over 80%. Stage Ib2 cervical cancer, however, is a high-risk early stage cervical cancer with easy recurrence and metastasis. Its 5-year survival is as low as about 50%. Thus how to increase survival and decreases mortality of stage Ib2 cervical cancer is a hot spot in genealogical cancer research. Materials and Methods General dataOne hundred and twelve young patients below 35 years with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January, 2003 to June, 2005. They ranged in age from 20 to 35 years with a median age of 32 years. The cases of cervical cancer were all confirmed as invasive cancer by our Department of Pathology, including (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

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supporting

confidence: 87%

Values of Three Different Preoperative Regimens in Comprehensive Treatment For Young Patients with Stage Ib2 Cervical Cancer

Zhao¹,

Wang²,

Chen³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…While an Italian trial and a meta-analysis has demonstrated that neoadjuvant cisplatin-based chemotherapy followed by radical surgery affords survival benefits in patients with stage IB2-IIB cervical cancer, 13,14 a recent phase III GOG trial failed to demonstrate any survival benefit. 15 The discrepancies in these results may be due to a variety of clinical and biological factors, and the use of different chemotherapeutic regimens based on cisplatin. [15][16][17][18] Several new drug regimens may have more activity in cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer

Cho

Kim

et al. 2009

J Gynecol Oncol

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Objective:To compare the efficacy of neoadjuvant chemotherapy with paclitaxel plus platinum followed by radical hysterectomy with radical surgery alone in patients with stage IB2-IIA bulky cervical cancer. Methods: From November 1999 to September 2007, stage IB2-IIA cervical cancers with tumor diameter ＞4 cm, as measured by MRI, were managed with two cycles of preoperative paclitaxel and platinum. As a control group, we selected 35 patients treated with radical surgery alone. Results: There were no significant between group differences in age, tumor size, FIGO stage, level of SCC Ag, histopathologic type and grade. Operating time, estimated blood loss, the number of lymph nodes yielded and the rate of complications were similar in the two groups. In surgical specimens, lymph-vascular space invasion (LVSI), nodal metastasis and parametrial involvement did not differ significantly between the two groups. In the neoadjuvant group, pathologic tumor size was significantly smaller and fewer patients had deep cervical invasion. Radiotherapy, alone and in the form of concurrent chemoradiation, was administered to more patients treated with radical surgery alone (82.9% vs. 52.9%, p=0.006). No recurrence was observed in patients who could avoid adjuvant radiotherapy owing to improved risk factors after neoadjuvant chemotherapy. There were no significant differences in 5-year disease free and overall survival. Conclusion: As neoadjuvant chemotherapy would improve pathologic prognostic factors, adjuvant radiotherapy can be avoided, without worsening the prognosis, in patients with locally advanced bulky cervical cancer. Neoadjuvant chemotherapy would be improving the quality of life after radical hysterectomy in patients with bulky cervical cancer.

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“…In more recent years randomised trials have examined whether giving cisplatin-based neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy, can improve outcome compared with surgery alone [42]; [43]; [44]; [45] Table 5). …”

Section: Neoadjuvant Chemotherapy Prior To Radical Surgery Versus Radmentioning

confidence: 99%

“…A total of 291 women with bulky stage IB cervical cancer were included [45]. Women in both arms who were found at surgery to have positive pelvic nodes, parametrial margins or positive para-aortic nodes were also given pelvic or extended-field radiotherapy.…”

Section: Neoadjuvant Chemotherapy Prior To Radical Surgery Versus Radmentioning

confidence: 99%

“…These trials provide the best opportunity to assess the effect of adding neoadjuvant chemotherapy to surgery, but only one found a survival benefit from neoadjuvant chemotherapy [43], and the others either found no overall benefit [42], [45] or a detriment from this treatment [44]. Operability was only increased in one trial [42] and adjuvant radiotherapy was given to between approximately 30 to 60% of women in these trials.…”

Section: Neoadjuvant Chemotherapy Prior To Radical Surgery Versus Radmentioning

confidence: 99%

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Concomitant and Neoadjuvant Chemotherapy for Cervical Cancer

Tierney¹,

Vale²,

Symonds³

2008

Clinical Oncology

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In the past, women with early stage cervical cancer have been treated with radical radiotherapy or radical surgery, and women with locally advanced disease with radical radiotherapy, each offering a good chance of cure. Numerous trials have investigated whether giving cytotoxic chemotherapy alongside radiotherapy or prior to local treatment could augment the established benefits of these therapies, and are reviewed here. There is a strong basis for the use of platinum-based chemoradiotherapy, the current standard of care, but little convincing evidence as to the therapeutic benefits of using concomitant hydroxyurea. Chemoradiotherapy based on other non-platinum agents may offer alternatives. The effect of chemoradiotherapy appears to vary according to the stage of disease, but all types of women benefit. Neoadjuvant chemotherapy prior to radiotherapy could jeopardise survival and should be avoided unless perhaps a 'quick', dose intense regimen is used. Neoadjuvant chemotherapy before surgery may be beneficial, but the approach will remain controversial until it is tested against platinum-based chemoradiotherapy. Future studies many include combinations of other cytotoxics such as topotecan with cisplatin-based concomitant chemoradiotherapy or the addition of agents targeted against specific receptors such as EGFR.

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Treatment of (“bulky”) stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: A phase III trial of the gynecologic oncology group

Cited by 149 publications

References 18 publications

Values of Three Different Preoperative Regimens in Comprehensive Treatment For Young Patients with Stage Ib2 Cervical Cancer

Values of Three Different Preoperative Regimens in Comprehensive Treatment For Young Patients with Stage Ib2 Cervical Cancer

Comparative study of neoadjuvant chemotherapy before radical hysterectomy and radical surgery alone in stage IB2-IIA bulky cervical cancer

Concomitant and Neoadjuvant Chemotherapy for Cervical Cancer

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