Neoadjuvant Chemotherapy for Early Stage Cervical Cancer Hilman Tadjoedin Division of Hematology-Medical Oncology, Department of Internal Medicine, School of Medicine – Dharmais National Cancer Centre Presented at HUT – RSKD, Audiotorium RSKD, November 9 th 2010
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Neoadjuvant Chemotherapy for Early Stage Cervical Cancer
Neoadjuvant Chemotherapy for Early Stage Cervical Cancer, dr. Hilman Tadjoedin, Sp. PD, KHOM - Division of Hematology-Medical Oncology, Department of Internal Medicine, School of Medicine – Dharmais National Cancer Centre
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Neoadjuvant Chemotherapy for Early Stage Cervical Cancer
Hilman Tadjoedin
Division of Hematology-Medical Oncology, Department of Internal Medicine,School of Medicine – Dharmais National Cancer Centre
Presented at HUT – RSKD, Audiotorium RSKD, November 9th 2010
Introduction :
• In the past 10 years : strategy of neoadjuvant chemotherapy (CT) → surgery +/- RT : great interest in cervical cancer (CC).
• Cispatine-based CT previously untreated locally advanced CC : high response rate.
• Few cases bulky early stage (IB - IIA ) : are included; long-term survival and complications are unknown due to short follow-up.
Introduction :
• Sardi et al : interim analysis of a prospective (including : sizable number of bulky stage IB).
• Unfortunately the design has been criticized :
1. Criteria of bulky
2. Lack of stratification of prognostic factors
3. Using 2 or 3 modalities → concern of overtreatment
• The course of PVB (cisplatin,vinblastin and bleomycin) is attractive in short recycling time → minimizing the possible accelerated repopulation of cancer cells.
Percentage of total Dollars by scientific area spent on Cervical Cancer FY 2002
Cervical Cancer mortality rates by country : 1970 - 1998
• Between 1988-1991 : bulky mass CC, treated at CGMH, with PVB neoadjuvant CT.
• Clinical response to CT, not different by : stage, histologic type, tumor size, level of squamous cell antigen or DNA ploidy; but tumor with high DNA indices (DI) > 1,3 higher clinical response rate.