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E u r o p e a n C o n g r e s s o n
Vaccines & Vaccination
and Gynecologic Oncology
Vaccines & Vaccination and Gynecologic Oncology 2018
O c t o b e r 2 6 - 2 7 , 2 0 1 8
B u d a p e s t , H u n g a r y
Critical Care Obstetrics and Gynecology
ISSN: 2471-9803
Objective:
A Randomized phase III trial was conducted to determine if neoadjuvant chemotherapy (NACT) prior to radical hysterectomy
and pelvic/para-aortic lymphadenectomy (RHPPL) could improve progression-free survival (PFS) and overall survival (OS), as well as
operability, with acceptable levels of toxicity. Adjuvant radiation therapy was prescribed for specific surgical/pathological risk factors
for both regimens.
Methods:
Eligible patients were required to have bulky FIGO stage IB cervical cancer, tumor diameter ≥4 cm, adequate bone marrow,
renal and hepatic function, and performance status ≤2. Prospective random allocation was to either NACT (vincristine-cisplatin chemo-
therapy every 10 days for 3 cycles) before exploratory laparotomy and planned RHPPL (NACT+RHPPL), or RHPPL only.
Results:
The study was closed prematurely, because of slow accrual, after 291 patients were enrolled, three were ineligible; thus 288
were eligible and randomly allocated to RHPPL (N=143) or NACT+RHPPL (N=145). There were no notable differences between regi-
mens regarding patients’ age, race, performance status, or tumour size. The median follow-up time is 62months among living patients.
The NACT+RHPPL group had very similar recurrence rates (relative risk: 0.998) and death rates (relative risk: 1.008) when compared to
the RHPPL group. There were 79% that had surgery in the RHPPL group compared to 78% in the NACT RHPPL group. There were 52%
who received post-operative RT in the RHPPL group compared to 45% in the NACT+RHPPL group (not statistically significant).
Conclusion:
There is no evidence from this trial that NACT offered any additional objective benefit to patients undergoing RHPPL for
suboptimal stage IB cervical cancer
.
zalousta217@gmail.comTreatment 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 gynaecologic
oncology group
Zeyad Esmael Alousta
Misurata medical centre, Libiya
Crit Care Obst & Gyne 2018, Volume: 4
DOI:10.21767/2471-9803-C1-003