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Ma Y.,Tianjin Medical University | Zhao G.,Tianjin Central Hospital for Obstetrics and Gynaecology | Qi J.,Tianjin Central Hospital for Obstetrics and Gynaecology | Sun P.,Tianjin Central Hospital for Obstetrics and Gynaecology | And 2 more authors.
Chinese Journal of Clinical Oncology | Year: 2013

Objective: This study aims to analyze the results of pre-operative brachytherapy and neoadjuvant chemotherapy followed by radical hysterectomy in cases of International Federation of Gynecology and Obstetrics (FIGO) stage I B2- II A cervical carcinoma and to investigate the effect of individualized treatment on cervical cancer. Methods: Cervical cancer cases treated with brachytherapy and chemotherapy before surgery in Tianjin Central Hospital for Obstetrics and Gynecology between June 2006 and June 2010 were reviewed. Results: Fifty patients received brachytherapy, pretoperative chemotherapy followed by redical hysterectomy and pelvic lymph node dissection. The median operating time was 195 min (range 110 min to 285 min) and the median blood loss was 583 mL (range 200 mL to 1400 mL). Among the 50 patients, 14 (28%) experienced an estimated blood loss of more than 800 mL during surgery and required blood transfusion, 4 experienced urinary retention, and 2 manifested thrombophlebitis. The postoperative febrile morbidity rate (>38°C for 2 days) was 6% (3/50) and the median time of recovery was 7 days (range 4 days to 18 days). Twelve patients (24%) exhibited positive lymph nodes, with parametrial invasion in 2 patients (4%) and positive incisal margin of the vagina in 1 patient (2%). Up to 23 patients had more than two intermediate risk factors. A total of 26 (52%) patients needed adjuvant therapy after surgery. Approximately 2 patients (4%) experienced long-term complications, such as G3 to G4 myelosuppression, 1 patient (2%) had proctitis and cystitis, and 2 patients (4%) had symptomatic vaginal stenosis. The morbidities of ureterohydronephrosis and lymphedema were 2% (1/50) and 6% (3/50), respectively. The median follow-up time was 43 months (range 24 months to 72 months). The three-year overall survival and disease-free survival rates were 90% CI (range 61.70 to 71.05) and 90% CI (range 61.61 to 71.10), respectively. Conclusion: Pre-operative brachytherapy and neoadjuvant chemotherapy are safe for the treatment of FIGO stage IB2-IIA cervical carcinoma and can achieve optimal survival rate and low complications. Source

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