Objectives. Concomitant chemoradiation is the “ new gold standard " for dealingwith locally advanced cervical carcinoma, but what about surgery? We don’ t know yet to what extent surgery is necessary and how ra...Objectives. Concomitant chemoradiation is the “ new gold standard " for dealingwith locally advanced cervical carcinoma, but what about surgery? We don’ t know yet to what extent surgery is necessary and how radical it must be when it is performed. In this study, we present the analysis of the results obtained in patients treated by concomitant chemoradiation followed by radical surgery. Materials and methods. Twenty-two patients, median age 49 years, with Ib-IIIa cervical tumors were enrolled to be treated by concomitant chemoradiation followed by radical surgery. The chemoradiation protocol included external radiotherapy to the pelvis: 45Gy ; Cisplatin 40mg/m2 in continuous intravenous infusion once a week (5 weeks) followed by brachytherapy one week later. Surgery was performed 4 to 6 weeks later and consisted in radical hysterectomy with pelvic lymphadenectomy. Results. 20/22 patients underwent surgery after chemoradiation because of a diagnosis of lung metastases in one and presence of a nonresectable metastasis for the other. A complete pathological response was demonstrated in 12/20 patients (60% ), a microscopic residual tumor in 7 patients (35% ), and residual disease <1cm in 1 patient (5% ). Conclusion. This study showed a particularly high rate of pathologic responses (T0+ Tmic: 95% ) and of local control. We don’ t know yet if surgery is a real necessity or if it could be less extended after concomitant chemoradiation.展开更多
文摘Objectives. Concomitant chemoradiation is the “ new gold standard " for dealingwith locally advanced cervical carcinoma, but what about surgery? We don’ t know yet to what extent surgery is necessary and how radical it must be when it is performed. In this study, we present the analysis of the results obtained in patients treated by concomitant chemoradiation followed by radical surgery. Materials and methods. Twenty-two patients, median age 49 years, with Ib-IIIa cervical tumors were enrolled to be treated by concomitant chemoradiation followed by radical surgery. The chemoradiation protocol included external radiotherapy to the pelvis: 45Gy ; Cisplatin 40mg/m2 in continuous intravenous infusion once a week (5 weeks) followed by brachytherapy one week later. Surgery was performed 4 to 6 weeks later and consisted in radical hysterectomy with pelvic lymphadenectomy. Results. 20/22 patients underwent surgery after chemoradiation because of a diagnosis of lung metastases in one and presence of a nonresectable metastasis for the other. A complete pathological response was demonstrated in 12/20 patients (60% ), a microscopic residual tumor in 7 patients (35% ), and residual disease <1cm in 1 patient (5% ). Conclusion. This study showed a particularly high rate of pathologic responses (T0+ Tmic: 95% ) and of local control. We don’ t know yet if surgery is a real necessity or if it could be less extended after concomitant chemoradiation.
