Abstract: Objective : To compare the outcome of preoperative vaginal intracavitary irradiation plus surgery and thatof surgery alone for patients with stage Ⅰb2 and Ⅱa cervical cancer, and to determine the value of preoperative vaginal intracavitary irradiation in patients treated by radical hysterectomy and pelvic lymphadenectomyfor stage Ⅰb2 and Ⅱa cervical cancer. Methods : From June 1998 to June 2005, data from 78 stage Ⅰb2 andⅡa cervical cancer patients (age≤75 years) with a diameter of local lesions greater than 4 cm were collectedin our hospital. Before treatment, all cases were confirmed by biopsy. The patients'general state was good,KPS grade≥90, heart and lung functioning was normal and patients were able to tolerate the surgery. The 78patients were randomly divided into two groups. Group 1 (n=38) received 2000~3000 cGy 192Ir irradiation frompreoperative intracavitary brachytherapy (radioactive source at 1 cm distance). After a rest of 10 to 14 days,radical hysterectomy with pelvic lymphadenectomy was performed. Group 2 (n=40) underwent radical surgerydirectly. The treatment outcomes between these two groups were compared and the effect of preoperative intracavitary brachytherapy and presence of postoperative complications were evaluated. Results : In group 1,the tumor volume shrunk after irradiation and the total response rate (CR+PR) was 94.7% (36/38). Preoperative intracavitary brachytherapy did not increase the rate of complications. The 1-, 3- and 5-year locoregionalcontrol rates were 89.5%, 82.9% and 76.9% in group 1 and 80.0%, 61.3% and 52.6% in group 2. A significantdifference was found in the 3- and 5-year locoregional control rates between the two groups (P<0.05). Therewas no significant difference between the two groups in the 1-, 3- and 5-year survival rates: 85.0% vs. 92.1%(P>0.05), 83.9% vs. 87.9% (P>0.05), and 78.3% vs. 80.0% (P>0.05), respectively. Conclusion : Preoperativeintracavitary brachytherapy is an effective procedure for the treatment for stage Ⅰb2 and Ⅱa cervical cancerand can significantly improve the locoregional control rate.