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

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/m(2), vincristine 1 mg/m(2) and cisplatin 75 mg/m(2) 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 > or =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.