The purpose of this study is: - to compare the effectiveness between the new strategy of treatment (given cis-platinum plus gemcitabine-neoadjuvant chemotherapy followed by surgery),and standard treatment (given cis-platinum/carboplatin during radiation-concurrent chemoradiation)in specific group of cervical cancer patients (stage Ib2-early IIb) - to evaluate quality of life in both group of patients(standard treatment vs.experimental group)

Brief Title

Comparing Study Between Concurrent Chemoradiation and New Combination Treatment in Cervical Cancer Patients

Official Title

Comparing Standard Concurrent Chemo-radiation to Neoadjuvant Chemotherapy Then Surgery or Radiation in Patients Stage Ib2-early IIb Cervical Carcinoma

Brief Summary

The purpose of this study is:<br /><br /> - to compare the effectiveness between the new strategy of treatment (given cis-platinum<br /> plus gemcitabine-neoadjuvant chemotherapy followed by surgery),and standard treatment<br /> (given cis-platinum/carboplatin during radiation-concurrent chemoradiation)in specific<br /> group of cervical cancer patients (stage Ib2-early IIb)<br /><br /> - to evaluate quality of life in both group of patients(standard treatment vs.experimental<br /> group)

Detailed Description

According to FIGO classification of cervical cancer, stage Ib2 was classified as clinically
visible lesion more than 4.0 cm in greatest dimension and stage IIb was classified tumor
invades parametrium must not to pelvic wall. These were the common stages in Thai cervical
cancer patients,and made a troublesome effect to Thai women. According to this study,stage
early IIb with 1/3 of parametrium involvement. Mostly these two stage was treated with
concurrent chemoradiation, challenging the possibility of late sequelae of radiation effect.
This specific group of patients can be avoid the referred side effect by using neoadjuvant
chemotherapy followed by radical hysterectomy with pelvic lymphadenectomy and para-aortic
node sampling in operable cases (at least partial response- PR) and concurrent chemoradiation
(CCR) in inoperable cases (less than PR). Due to high risk type of these subspecific group,
combination chemotherapy instead of single chemotherapy was used as CCR. However in operable
cases with identified poor prognostic factor should be receive post operative radiation as
the usual manner.