Study of preoperative chemotherapy in cervical cancers stages IB2, IIA2 and IIB.

Sujay, Susikar (2013) Study of preoperative chemotherapy in cervical cancers stages IB2, IIA2 and IIB. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION : Cervical cancer is among the commonest cancers affecting women worldwide. It is the seventh commonest cancer affecting an estimated 530,000 new women in 2008, accounting for 4.2% among all cancers. It is the third commonest cancer among women causing 8.8% of all cancers in women. In developing countries, it increases to 13% of all cancers in women. The incidence and mortality rates are higher in low and middle income countries. Even in these countries, the highest incidence and mortality rates are seen in the low socio-economic groups which further exemplify the health inequity of this disease. Cervical cancer tops the list among cancers among women in certain parts of Asia and Africa. The low risk regions are Western Asia, North America, Australia and New Zealand. Overall, the mortality rate is 52%.The estimated death due to cervical cancer was 275000 in 2008 and 88% of these occurred in developing countries. There is a seventeen fold difference in mortality due to cervical cancer among different regions of the world. AIM : To assess the efficacy of neoadjuvant chemotherapy followed with radical hysterectomy as an alternative to irradiation in bulky carcinoma cervix. To compare 2 two drug regimens- (Paclitaxel and Cisplatin with 5FU and cisplatin). To assess if pathologic response has prognostic value on survival. CONCLUSION : Preoperative chemotherapy in carcinoma cervix is effective in reducing tumor volume and the stage of the disease making bulky stage IB, IIA and IIB disease operable. It may present an attractive option in patients with bulky inoperable tumors of the cervix avoiding radiation and keeping it in reserve for the salvage of recurrences. Paclitaxel with cisplatin yields better response rates (more complete responses) than 5FU and cisplatin and maybe a better drug combination for preoperative chemotherapy in carcinoma cervix. Neoadjuvant chemotherapy with Paclitaxel and cisplatin followed by radical surgery for patients with bulky inoperable cervical Squamous cell carcinoma is a promising mode of treatment that may improve the prognosis. The response rates were good, but longer term follow up is required to assess the benefit on survival and disease free rates. It would be worthwhile to conduct larger-scale trials with a longer follow up for comparison with the results of the chemoradiation therapy study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: preoperative chemotherapy; cervical cancer ; stage IB2, stage IIA2 ; stages IIB.
Subjects: MEDICAL > Surgical Oncology
Depositing User: Kambaraman B
Date Deposited: 25 Jul 2017 04:35
Last Modified: 25 Jul 2017 05:47

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