For the treatment of bulky cervical cancer, the most promising modality is surgery followed neoadjuvant chemotherapy( NAC-S)or concurrent chemoradiation therapy (CCRT). The purpose of this study is to compare the efficacy and complications associated with each treatment. The CCRT group included significantly more elderly and advanced patients than the NAC-S group. From 2001 to 2005, 76 consecutive previously untreated patients with bulky cervical cancer staged as I b2- III b were treated with NAC-S or CCRT. The response rate of NAC was 63% and 84% of patients received radical surgery. There was no significant difference in the intra-pelvic or extra-pelvic recurrence rate between NAC-S and CCRT group. In addition, there was no significant difference in 3-year relapse-free survival or overall survival. When we consider the bias, these results suggest that CCRT is superior to NAC-S.
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