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Phase II study of neoadjuvant chemotherapy with mitomycin-c, vincristine and cisplatin (MVC) in patients with stages IB2–IIB cervical carcinoma

  • Chel Hun Choi
    Affiliations
    Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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  • Tae-Joong Kim
    Affiliations
    Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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  • Jeong-Won Lee
    Affiliations
    Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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  • Author Footnotes
    1 The two authors contributed equally to this paper and are authors for co-correspondence.
    Byoung-Gie Kim
    Footnotes
    1 The two authors contributed equally to this paper and are authors for co-correspondence.
    Affiliations
    Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
    Search for articles by this author
  • Je-Ho Lee
    Affiliations
    Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
    Search for articles by this author
  • Author Footnotes
    1 The two authors contributed equally to this paper and are authors for co-correspondence.
    Duk-Soo Bae
    Correspondence
    Corresponding author. Fax: +82 2 3410 0630.
    Footnotes
    1 The two authors contributed equally to this paper and are authors for co-correspondence.
    Affiliations
    Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
    Search for articles by this author
  • Author Footnotes
    1 The two authors contributed equally to this paper and are authors for co-correspondence.

      Abstract

      Objective

      The efficacy and toxicity of neoadjuvant chemotherapy (NAC) with mitomycin-C, vincristine and cisplatin (MVC) were assessed in bulky cervical carcinoma patients.

      Methods

      Forty-six patients with stage IB2 to IIB cervical cancer were treated with intravenous combination of mitomycin-C 10 mg/m2, vincristine 1 mg/m2 and cisplatin 75 mg/m2 every 3 weeks. After three cycles of NAC, the patients either underwent surgery or radiation therapy, depending on their suitability for radical hysterectomy.

      Results

      All 46 patients enrolled in this study were suitable for surgery after NAC. Twenty (44%) patients had risk factors after surgery and received postoperative radiation. Toxic nonhematologic reactions consisted primarily of grades 1–2 nausea and vomiting (87%) and the most common hematologic toxicity was anemia (60%). Clinical responses occurred in 83% (38/46) of patients, including 24% (11/46) with a complete response (CR) and 13% (6/46) with a pathologically determined complete response. For a median follow up period of 28 months, the 3-year disease-free and overall survival rates were 74% and 80%, respectively. Pathologically confirmed lymph node metastasis or parametrial involvement and an initial tumor size ≥4 cm were associated with shorter disease-free survival (P=0.040, P=0.000, P=0.025, respectively).

      Conclusion

      Intravenous administration of MVC as a NAC seems to be well tolerated and beneficial in patients with stage IB2 to IIB cervical cancer.

      Keywords

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