Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
Gynecol Oncol. 2013 Apr;129(1):124-8. doi: 10.1016/j.ygyno.2013.01.011. Epub 2013 Jan 24.
To evaluate role of dose dense neo-adjuvant chemotherapy (NACT) prior to standard concurrent chemo-radiation (CCRT) in locally advanced cervical cancer.
Between June 2010 and December 2011, 28 patients (median age - 51 years, range, 35 to 67 years) with locally advanced cervical cancer received NACT using paclitaxel (60 mg/m(2)) and carboplatin (AUC-2) weekly for 6 doses. After a mean interval of 15 days (range 7-23 days), the patients then received definitive radiation and concomitant weekly infusion of cisplatin (40 mg/m(2) for 6 doses). Response to concurrent chemo-radiation and toxicity were end points.
Following NACT, 67.8% of patients responded; complete (CR) - 2(7.1%), Partial (PR) - 17 (60.7%), stable 7 (25.0%) and 2 patients (7.1%) progressed. 24 of 28 patients received CCRT; 23/24 achieved CR. 22 of 23 complete responders continue to be in CR at a median follow-up of 12 months (range, 7 to 24 months). Grade III/IV neutropenia was the main hematological toxicity seen in 28.5% and 29% of patients, respectively during NACT and CCRT.
Neoadjuvant chemotherapy with dose dense weekly paclitaxel and carboplatin followed by standard CCRT is a feasible approach and is associated with a high response rate in locally advanced cervical cancer.
评估在标准同步放化疗（CCRT）前进行剂量密集型新辅助化疗（NACT）在局部晚期宫颈癌中的作用。
2010 年 6 月至 2011 年 12 月，28 例局部晚期宫颈癌患者（中位年龄 51 岁，范围 35 至 67 岁）接受每周紫杉醇（60mg/m2）和卡铂（AUC-2）剂量密集型 NACT，共 6 个剂量。在平均间隔 15 天后（范围 7-23 天），患者接受根治性放疗和每周顺铂（40mg/m2，共 6 个剂量）同步治疗。同步放化疗的反应和毒性为终点。
NACT 后，67.8%的患者有反应；完全缓解（CR）-2（7.1%），部分缓解（PR）-17（60.7%），稳定 7（25.0%），2 例（7.1%）进展。28 例患者中有 24 例接受 CCRT；24/24 例达到 CR。23 例完全缓解者中有 22 例在中位随访 12 个月（范围 7 至 24 个月）时仍处于 CR。NACT 和 CCRT 期间，分别有 28.5%和 29%的患者出现 III/IV 级中性粒细胞减少症。
每周紫杉醇和卡铂剂量密集型 NACT 联合标准 CCRT 是一种可行的方法，在局部晚期宫颈癌中具有较高的反应率。
