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Use of neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer: monitoring tumour shrinkage and molecular profile on magnetic resonance and assessment of 3-year outcome

Authors
Journal
British Journal of Cancer
0007-0920
Publisher
Nature Publishing Group
Publication Date
Identifiers
DOI: 10.1038/sj.bjc.6601870
Keywords
  • Clinical
Disciplines
  • Biology
  • Ecology
  • Medicine

Abstract

Use of neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer: monitoring tumour shrinkage and molecular profile on magnetic resonance and assessment of 3-year outcome NM deSouza*,1, WP Soutter2, G Rustin6, MM Mahon5, B Jones4, R Dina3 and GA McIndoe2 1Department of Imaging, Hammersmith Hospital, DuCane Road, London W12 0HS, UK; 2Departments of Obstetrics and Gynaecology, Hammersmith Hospital, DuCane Road, London W12 0HS, UK; 3Department of Histopathology, Hammersmith Hospital, DuCane Road, London W12 0HS, UK; 4Department of Radiation Oncology, Hammersmith Hospital, DuCane Road, London W12 0HS, UK; 5The Robert Steiner MR Unit, Hammersmith Hospital, DuCane Road, London W12 0HS, UK; 6Department of Medical Oncology, Mount Vernon Hospital, Middlesex, UK The objective of this study is to assess tumour response to neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer using magnetic resonance (MR) to monitor tumour volume and changes in molecular profile and to compare the survival to that of a control group. Eligibility included Stage Ib– IIb previously untreated cervical tumours 410 cm3. Neoadjuvant chemotherapy in 22 patients (methotrexate 300 mg m�2 (with folinic acid rescue), bleomycin 30 mg m�2, cisplatin 60 mg m�2) was repeated twice weekly for three courses and followed by radical hysterectomy. Post-operative radiotherapy was given in 14 cases. A total of 23 patients treated either with radical surgery or chemoradiotherapy over the same time period comprised the nonrandomised control group. MR scans before and after neoadjuvant chemotherapy and in the control group documented tumour volume on imaging and metabolites on in vivo spectroscopy. Changes were compared using a paired t-test. Survival was calculated using the Kaplan–Meier method. There were no significant differences between the neoadjuvant chemotherapy and control groups in age (mean, s.d. 43.3710, 44.778.5 years, respectively, P¼ 0.63) or tumour volume (medians, quartiles 35.8, 17.8, 57.7

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