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Giuseppa Scandurra,Giuseppe Scibilia,Giuseppe Luigi Banna,Gabriella D’Agate,Helga Lipari,Stefania Gieri,Paolo Scollo 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.2
Objective: To evaluate the efficacy and tolerability of a neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy inpatients with locally advanced cervical carcinoma. Methods: Patients with histologically confirmed locally advanced cervical carcinoma, aged ≥18 years, were treated withintravenous ifosfamide 5,000 mg/m2 and mesna 5,000 mg/m2, on day 1; intravenous paclitaxel 175 mg/m2 and cisplatin 75 mg/m2, on day 2; every 3 weeks for three cycles. Following chemotherapy, operable patients underwent radical hysterectomy andpelvic lymphadenectomy, and, if necessary, adjuvant radiotherapy. Results: One hundred fifty-two patients with median age 53 years (range, 24 to 79 years), FIGO stage IIB in 126 (89%), weretreated with chemotherapy for median 3 cycles (range, 1 to 3). Treatment was delayed or withdrawn in 23 patients (15%). Onehundred thirty-nine patients (91%) underwent surgery. Postchemotherapy pathological complete response rate was 18% (25patients). Postoperative radiotherapy was administered in 100 patients (72%). The 5-year overall survival and progression-freesurvival were 87.3% (95% confidence interval [CI], 84.5 to 90.3) and 76.4% (95% CI, 73.5 to 79.5), respectively. Conclusion: Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy was feasible and effective in the treatment oflocally advanced cervical carcinoma patients with older age and more advanced disease stage than reported in previous studies. Hematological and renal toxicity could be carefully prevented.