neoadjuvant chemotherapy with vincristine and cisplatin followed by radical hysterectomy and pelvic lymph adenectomy for figo stage ib bulky cervical cancer

twenty patients with bulky (>4 cm size) figo stage ib cervical cancer were treated with cisplatin 50 mg/m2 and vincristine 1 mg/m2, administered intravenously at 10-day intervals for a total of 3 courses before radical hysterectomy. a complete clinical response was noted in 1 patient (5%) and partial response in 5 (25%). fourteen patients (70%) had stable disease. there was no grade 3 toxicity noted. of the 20 patients who received chemotherapy (cht), 3 patients had parametrial and para-aortic involvement in these cases, the operation was aborted and radiation therapy given. the remaining 17 patients underwent radical hysterectomy and pelvic lymphadenectomy 10-15 days following cht. five of these patients (29.4%) had pelvic node metastases. three patients had positive margins. these 8 patients received postoperative radiotherapy. twenty-four months later 15 patients were alive (87%) and 2 had died.