Abstract:

Objective The purpose of this study is to compare long-term survival of neoadjuvant chemotherapy followed by radical hysterectomy with concurrent chemoradiotherapy in locally advanced cervical cancer.Methods A total of 222 stageⅠB2-ⅡB locally advanced cervical cancer cases from January 2000 to December 2004 were analyzed retrospectivly.All the cases were divided into two groups:155 cases of neoadjuvant chemotherapy followed by radical hysterectomy with pelvic lymph node dissection(NACT + RS group);67 cases of concurrent chemoradiotherapy group(CCRT group).Patients were followed up from 54 to 114 months,NACT group patients were followed up for more than 72.6 months,all risk factors that may affect the disease-free survival(DFS)and overall survival(OS)were assessed.The NACT+RS group had significantly higher survival rates than both the CCRT(DFS:hazard ratio=2.765,P=0.0021;OS:hazard ratio=3.516,P=0.0002)groups.Results In this study,median follow-up time was 72.6 months,the five-year DFS rates of the NACT+RS and CCRT groups were 88.39% and 70.94%,respectively(P=0.006),while the five-year OS rates were 88.52% and 72.91%,respectively(P=0.0004).Conclusion There was no significant difference in both the short-term effect and complete remission rate between NACT + RS group and CCRT group on stage ⅠB2-ⅡB locally advanced cervical cancer patients;it was significantly better on DFS and OS of NACT + RS group than that of CCRT group.

Key words: Cervical carcinoma, Neoadjuvant chemotherapy, Radical hysterectomy, Concurrent chemoradiotherapy