Department of Gynecologic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
Int J Gynecol Cancer. 2011 May;21(4):685-9. doi: 10.1097/IGC.0b013e3182129b61.
The commonly used administration schedule of irinotecan in combination therapy with cisplatin in cervical cancer was once weekly for 3 weeks. To some extent, this administration schedule may be inconvenient for patients who were far from hospital. The aim of the current study is to investigate the efficacy and toxicities of a modified shortened administration schedule for neoadjuvant chemotherapy with irinotecan and cisplatin in locally advanced cervical cancer.
We retrospectively reviewed the clinical records of patients with cervical cancer who received neoadjuvant chemotherapy with irinotecan and cisplatin delivered by the modified administration schedule at Sun Yat-sen University Cancer Center from November 2005 to May 2010. Irinotecan was administrated by intravenous infusion for 1 hour at a dose of 80 mg/m on days 1 and 8. Cisplatin was administrated intravenously at a total dose of 60 to 70 mg/m, which was infused on day 1 or was divided into 2 or 3 doses and given on days 1 to 2 or 3. The treatment was repeated every 3 weeks.
The total response rate was 78.8% (42/52), including a complete response and partial response rate of 11.5% (6/52) and 67.3% (35/52), respectively. Pathologically confirmed complete response was noted in 7.7% (4/52) of patients. Stable disease was observed in 17.3% (9/52) of patients and progression disease in 3.8% (2/52) of patients. Diarrhea and hematological toxicity were the major dose-limiting toxicities. Diarrhea occurred in 23.1% of patients with grades 1, 2, and 3 in 11.5%, 7.7%, and 3.8% of patients, respectively. No grade 4 diarrhea was noted. Grade 3/4 neutropenia developed in 7.7% (4/52) of patients. Grade 3/4 anemia occurred in 19.2% (10/52) of patients.
The modified shortened administration schedule of combined therapy with irinotecan and cisplatin may be active against cervical cancer as neoadjuvant chemotherapy. The adverse effects could be controllable.
伊立替康联合顺铂在宫颈癌的联合治疗中常用的给药方案是每周给药 3 周。在某种程度上，这种给药方案可能对远离医院的患者不太方便。本研究旨在探讨改良的伊立替康和顺铂新辅助化疗短程给药方案在局部晚期宫颈癌中的疗效和毒性。
我们回顾性分析了中山大学肿瘤防治中心 2005 年 11 月至 2010 年 5 月接受伊立替康和顺铂改良给药方案新辅助化疗的宫颈癌患者的临床资料。伊立替康静脉输注 1 小时，剂量为 80mg/m，第 1 天和第 8 天。顺铂静脉滴注，总剂量 60-70mg/m，第 1 天给药或分为 2-3 次，第 1-2 天或第 3 天给药。每 3 周重复一次。
总有效率为 78.8%（42/52），其中完全缓解和部分缓解率分别为 11.5%（6/52）和 67.3%（35/52）。病理完全缓解率为 7.7%（4/52）。稳定疾病占 17.3%（9/52），进展疾病占 3.8%（2/52）。腹泻和血液学毒性是主要的剂量限制毒性。腹泻发生率为 23.1%，其中 11.5%、7.7%和 3.8%的患者分别为 1 级、2 级和 3 级。未观察到 4 级腹泻。3/4 级中性粒细胞减少发生率为 7.7%（4/52）。3/4 级贫血发生率为 19.2%（10/52）。
改良的伊立替康和顺铂联合治疗短程给药方案作为新辅助化疗可能对宫颈癌有效。不良反应是可控的。
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