e16532 Background: The management of locally advanced squamous cell cervical carcinoma includes chemoradiotherapy or neoadjuvant cisplatin based chemotherapy followed by surgery, that may offer specific advantages a better potential activity. Porpouse: To evaluate efficacy and safety of TIP neoadjuvant chemoregimen in patiens affects by local advanced squamous cell cervical carcinoma. Methods: July 1997 - December 2011 were treated at our institution 165 patients with locally advanced squamous cell cervical carcinoma of whom 143 are evaluable. Regimen: Ifosfamide 5000 mg/mq ev day 1 iv in 24 h ; Mesna 5000 mg/mq ev day 1 iv in 24 h ; Paclitaxel 175 mg/mq ev day 2; Cisplatin 75 mg/mq ev day 2; every 3 weeks for a total of three courses. Tumor extension was assessed clinically and by abdominal MRI, PET WB and 3D ultrasound at baseline and after three courses.The operable patients after TIP chemoterapy underwent radical hysterectomy and pelvic lymphadenectomy. The median age 53 ( range 24-79 yrs), clinical FIGO stage Ib 2 2 pts(1%) , IIb 59 pts(41%), IIb bulky 68 pts (48%), III-IV 14 pts (10%), histological subtype SCC 138 pts (96%) and adenocarcinoma 5 pts ( 4%). Results: After neoadjuvant chemiotherapy 132 pts (92%) underwent surgery. Post-chemotherapy pathological response was pCR 25 pts (19%), PR1 16 pts (12%), PR2 80 pts (61%), SD 10 pts (7%), PD 1 pt (1%). Median numbers of courses of TIP administrated was 3 ( range 1-3). Treatments was delay or withdrawal in 22 pts ( 16%). Treament limiting toxicities were, Neutropenia 11 pts (52%), Anemia 10 pts (45%),Thrombocytopenia 7 pts (33 %), Renal failure 3 pts (14 %), Allergic reaction 3 pts (14%), Vomiting 3 pts (14%), Febrile neutropenia 2 pts (10%), Hypopotassiemia1 pt (5%), Atrial fibrillation 1pt( 5%), Pneumonia 1 pt (5%). Conclusions: In our experience neoadjuvant TIP was feasible, effective with 92% resection rate and active in an older and higher stage disease enriched series than reported in previous clinical trials.
A phase II, randomized trial of neo-adjuvant chemotherapy comparing a three-drug combination of paclitaxel, ifosfamide, and cisplatin (TIP) versus paclitaxel and cisplatin (TP) followed by radical surgery in patients with locally advanced squamous cell cervical carcinoma: the Snap-02 Italian Collaborative Study