Objectives. This study aimed to evaluate the efficacy and toxicity of gemci ta bine in combination with cisplatin as neoadjuvant therapy in patients with cervi cal carcinoma stage IB2. Patients and methods. Chemotherapy-naive patients wit h histologic diagnosis of squamous cell cervical carcinoma staged as IB2 were tr eated with 2 cycles of cisplatin (70 mg/m2 on day 1) and gemcitabine (1000 mg/m2 on days 1 and 8), given every 21 days. After chemotherapy, patients underwent r adical hysterectomy and pelvic lymphadenectomy. Patients judged to have a nonres ectable disease were treated with standard pelvic radiation. Results. Between Se ptember 2000 to March 2004, 28 patients were enrolled in the study, of which 27 were evaluable for efficacy and toxic ity. The mean age was 39 years (30- 55). The overall clinical response rate was 88.9% (24/27), with complete response (CR) in 9/27 patients (33.3% ) and par tial response in 15/27 patients (55.5% ). Three patients (11.1% ) did not resp ond and nobody progressed. A pathological CR was noted in 2 of 24 patients who u nderwent radical surgery. The 3 non-responding patients were subsequently trea ted with radiation and achieved CR. Grades 3 or 4 neutropenia, anemia, or thromb ocytopenia was observed in 18.5% , 7.4% , and 3.7% patients respectively. No n-hematological toxicity was mild except grade 3 nausea/vomiting in 18.5% pa tients. At median followup time of 36.7 months (range 7- 51 months), the 3- ye ar survival was 88.9% . Conclusion. Neoadjuvant treatment with gemcitabine/cisp latin combination for patients with cervical cancer (stage IB2) appears encourag ing, with manageable and acceptable toxicity profile.
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