The Effects of FAC neoadjuvant Chemotherapy in Locally Advanced and Bulky Cervical Cancer

Lee, In Sook; Jang, Kyung Tack; Choi, Kyu Yun; Sunwoo, Jae Kun; Bae, Dong Han

Abstract

The goals of any new cervical cancer chemotherapy should include; a decrease in toxicity, better distant and local control of the disease, prolongation of survival, improvement in the quality of life and palliation of symptoms. The goal of FAC (5-Fluorouracil, Interferon alpha-2a, Carboplatin) neoadjuvant chemothe-raphy is for better surgical therapeutic results in locally advanced and bulky lesions with preo-perative chemotheraphy. This new trend in management of cervical cancer may provide the benefits as follows; reduction of the tumor size, a decrease in numbers of involved lymph nodes, control of microscopically metastatic lesions, improvement of the effects of radiation therapy and providing the chance of operability by lowering the clinical stage than initial prechemotherapy stage. The purpose of this study is to evaluate the effect of FAC neoadjuvant chemotherapy on reducing the size of tumors in cervical cancer. 17 patients in stage I b2, IIa, IIb carcinoma of cervix were treated with FAC regimen; Interferon alpha-2a 6 MIU given subcutaneously on day 1~6, 5-Fluorouracil 750 mg/m(2) given intravenously on day 2~6 and Carboplatin 350 mg/m2 given intravenously on 2nd day. The overall response rate was 58.5%, including 2 complete responses(11.7%) and 8 partial responses(47.1%). Neoadjuvant chemotherapy reduced the mean cervical lesion area from 23.1+9.97 cm(2) to 8.65+5.95 cm(2) in response group. The toxicity was acceptable in this group and the frequent toxicity was myelosuppression. Although limitation of this study are the lack of randomization and the small sample size, FAC neoadjuvant chemotheraphy is a potentially useful modality in the management of patients with locally advanced bulky cervical cancer.