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자궁경부암 원통형 및 거대내자궁병소에 대한 관해항암화학요법의 치료효과
조수현,이정한,김승룡,황정혜,조삼현,이재억,류기영,황윤영,공미숙,문형,김경태,이문휘 대한부인종양 콜포스코피학회 1999 Journal of Gynecologic Oncology Vol.10 No.2
Objectives: This retrospective study was conducted to analyze the hypothesis that with neoadjuvant chemotherapy of vinblastine, bleomycin, and cisplatin followed by radical hysterectomy or radiation therapy and concurrent chemoradiation with cisplatin based regimen would improve survival in patients with barrel-shaped or bulky-endophytic (Diameter $gt; 4cm) cervical carcinomas than those of radiation alone or combined radiation and surgery. Study design: Eighty-eight patients with barrel-shaped or bulky-endophytic cervical carcinomas, treated at the Hanyang University Hospital from 1983 to 1997, were the subjects of this investigation. Fifty-six of these patients were treated by neoadjuvant chemotherapy followed by radical hysterectomy with bilateral pelvic lymphadenectomy ( Stage I b2, 8; IIa, 15; IIb, 20; III- IV, 13), twelve patients were treated by neoadjuvant chemotherapy followed by radiation therapy ( Stage IIb, 4; III-IV, 8), and twenty patients were treated by concurrent chemo-radiotherapy ( Stage IIb, 2; III-IV, 18). Results: The incidence of parametrial extension and pelvic lymphnode metastases was higher in patients with barrel-shaped or bulky-endophytic cervical carcinomas than non-barrel-shaped cervix (p=.025 : .001). 5-years disease free survival rate was determined for patients treated by neoadjuvant chemotherapy followed by radical hysterectomy with bilateral pelvic lymphadenectomy was 73.3 %. For patients treated by neoadjuvant chemotherapy followed by radiation therapy it was 45.7%. For patients treated by concurrent chemo-radiotherapy it was 46.1%. Conclusion: These data support an improvement in survival of patients with barrel-shaped or bulky-endophytic cervical carcinomas treated by neoadjuvant chemotherapy followed by radical hysterectomy or radiation therapy and concurrent chemo-radiotherapy.