High-dose density neoadjuvant chemotherapy in bulky IB cervical cancer
Language English Country United States Media print-electronic
Document type Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
PubMed
23063763
DOI
10.1016/j.ygyno.2012.10.002
PII: S0090-8258(12)00804-9
Knihovny.cz E-resources
- MeSH
- Chemotherapy, Adjuvant MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local MeSH
- Uterine Cervical Neoplasms drug therapy mortality pathology MeSH
- Disease-Free Survival MeSH
- Prospective Studies MeSH
- Aged MeSH
- Neoplasm Staging MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVE: The endpoint of this prospective study is to evaluate response rate, survival and toxicity of high-dose density neoadjuvant chemotherapy (NAC) in bulky IB cervical cancer. MATERIAL AND METHODS: Between January 1998 and December 2009, 154 women were enrolled into study. Three patients were withdrawn. Of the 151 women, 119 had stage IB2 cervical cancer (78.8%) and 32 had stage IB1 cancer (21.2%) infiltrating the whole cervical stroma. Women received 3-4cycle cisplatin-75mg/m(2) and ifosfamide-2g/m(2) in cases of squamous-cell cancer or cisplatin-75mg/m(2) and doxorubicin-35mg/m(2) in adenocarcinoma every 10days and then underwent radical hysterectomy type III. Patients who had non-resectable disease underwent chemoradiotherapy. RESULTS: The overall response rate (reduction of tumor volume more than 50%) was 78.8%. Reduction of tumor volume less than 50% was seen in 15.2%. Tumor progression during chemotherapy occurred in nine patients (6.0%). There were positive lymph-nodes in 26 patients (18.3%) of the 142 that underwent surgery. 38 women underwent adjuvant radiotherapy (26.7%). There were 26 recurrences (17.2%). After surgery 20 women recurred from 142 (14.1%) and after primary radiotherapy 6 from 9 women recurred (66.7%). 25 of 151 women died from disease (16.5%). At the time of the study, surgery was performed in 118 women 5 or more years ago, 19 of them died of disease. Five-year specific survival is 83.6%. Grade 3-4 neutropenia was found in only 7.3% of the women, and grade 3-4 thrombocytopenia were found in 1.3%. CONCLUSION: High-dose density NAC appears to be feasible in the treatment IB bulky cervical cancer and toxicity is acceptable. Adjuvant radiotherapy was used only in 26.7%.
Department of Obstetrics and Gynecology 2nd Medical Faculty Charles University Prague Czech Republic
Department of radiology 2nd Medical Faculty Charles University Prague Czech Republic
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