Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Eur J Obstet Gynecol Reprod Biol. 2012 Oct;164(2):200-4. doi: 10.1016/j.ejogrb.2012.06.008. Epub 2012 Jul 4.
An effective salvage chemotherapy for advanced and recurrent non-squamous carcinoma of the uterine cervix has not yet been established. The aim of the present study was to analyze the safety and efficacy of a combination chemotherapy for this disease using taxane, anthracycline, and platinum.
This was a retrospective analysis of advanced and recurrent non-squamous cervical cancers treated at the Osaka University Hospital and the Osaka Medical Center for Cancer and Cardiovascular Diseases during a 10 year study period from 2000 to 2009. Single agent chemotherapies and combination chemotherapies for advanced and recurrent cervical cancer cases of non-squamous histology which were reported in the English literature were also reviewed.
Salvage chemotherapy, using taxane, anthracycline and platinum, was performed for 5 advanced and 14 recurrent cases. Prior to the salvage chemotherapy, 15 (79%) of the 19 patients had already received either radiation or chemotherapy. A complete or partial tumor response was achieved in 8 (42%) of the 19 cases. The response rate for recurrent disease in a previously irradiated field was 40%. The median progression-free survival (PFS) and overall survival (OS) were 8 months (1-108) and 13 months (5-108), respectively. Grade 4 and febrile grade 3 neutropenia was observed in 6 cases (32%), but there was no case in which salvage chemotherapy had to be cancelled due to toxicity. According to previous reports, the cumulative response rate of combination chemotherapy (35%) was significantly higher than that of single agent chemotherapy (17%) (p<0.001). OS tended to be longer in the combination chemotherapy cases (8.7 months to 18 months) than that of single agent chemotherapy cases (7.3+ months to 9.1+ months).
Combination chemotherapy of taxane, anthracycline, and platinum was found to have a survival benefit for advanced and recurrent cervical cancer patients of non-squamous carcinoma histology, with a tolerable toxicity.
对于晚期和复发性非鳞状宫颈癌，尚未建立有效的挽救化疗。本研究旨在分析使用紫杉烷、蒽环类药物和铂类药物联合化疗治疗该病的安全性和疗效。
这是一项回顾性分析，纳入了 2000 年至 2009 年期间在大阪大学医院和大阪医疗中心癌症和心血管疾病治疗的晚期和复发性非鳞状宫颈癌患者。还回顾了英文文献中报道的晚期和复发性非鳞状宫颈癌患者的单药化疗和联合化疗。
对 5 例晚期和 14 例复发性非鳞状宫颈癌患者进行了紫杉烷、蒽环类药物和铂类药物的挽救化疗。在挽救化疗前，19 例患者中有 15 例（79%）已接受放疗或化疗。19 例患者中 8 例（42%）达到完全或部分肿瘤缓解。在既往放疗野中复发性疾病的缓解率为 40%。中位无进展生存期（PFS）和总生存期（OS）分别为 8 个月（1-108）和 13 个月（5-108）。6 例（32%）出现 4 级和发热性 3 级中性粒细胞减少症，但无因毒性而必须取消挽救化疗的病例。根据以往报道，联合化疗的累积缓解率（35%）明显高于单药化疗（17%）（p<0.001）。联合化疗组的 OS 倾向于长于单药化疗组（8.7 个月至 18 个月）（7.3+个月至 9.1+个月）。
紫杉烷、蒽环类药物和铂类药物联合化疗对非鳞状宫颈癌晚期和复发性患者具有生存获益，且毒性可耐受。
