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.