Ma Ke, Yang Yi-he, Yang Xi, Feng Zhao-Yi, Liu Tong-yu, Wen Hong-wu, Liao Qin-ping
Department of Obstetrics and Gynecology, Peking University First Hospital, Peking 100034, China.
Department of Preventive Medicine, Northwestern University, Chicago 60611, USA.
Beijing Da Xue Xue Bao Yi Xue Ban. 2013 Dec 18;45(6):910-5.
To evaluate the effectiveness of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy plus postoperative chemotherapy but no radiotherapy for stage IB2-IIB cervical cancer.
Seventy-nine patients with stage IB2-IIB cervical cancer were treated with NAC followed by radical hysterectomy. According to different adjuvant therapies, patients were divided into postoperative chemotherapy group (47 cases) and postoperative radiotherapy/concurrent chemoradiotherapy group (32 cases). Regimens for NAC and postoperative chemotherapy were BIP (bleomycin+ ifosfamide+ cisplatin/carboplatin) or TP (paclitaxel+ cisplatin/carboplatin). An average of 1.1±0.3 cycles of NAC and 3.4±1.2 cycles of postoperative chemotherapy were prescribed.
Toxicities due to chemotherapy were generally tolerable. Overall response rate of NAC was 88.6%. With a median follow-up period of 42 months, the three-year progression-free survival rates of the two groups were 88.5% and 84.3%, the total survival rates were 90.3% and 86.4%, respectively. There was no statistically significant difference. The recurrent rates were 10.6% and 21.8% in the two groups. In the absence of radiotherapy, pelvic recurrence was observed in two patients; the other three had distant metastases.
The results indicate that NAC followed by surgery plus postoperative chemotherapy but no radiotherapy offers a viable option in the treatment of stage IB2-IIB cervical cancer. The patients can tolerate the side effects of chemotherapy with better efficacy.
评估新辅助化疗(NAC)后行根治性子宫切除术加术后化疗但不放疗治疗IB2-IIB期宫颈癌的有效性。
79例IB2-IIB期宫颈癌患者接受NAC后行根治性子宫切除术。根据不同的辅助治疗方法,患者分为术后化疗组(47例)和术后放疗/同步放化疗组(32例)。NAC和术后化疗方案为BIP(博来霉素+异环磷酰胺+顺铂/卡铂)或TP(紫杉醇+顺铂/卡铂)。NAC平均疗程为1.1±0.3个周期,术后化疗平均疗程为3.4±1.2个周期。
化疗所致毒性一般可耐受。NAC的总缓解率为88.6%。中位随访期为42个月,两组的三年无进展生存率分别为88.5%和84.3%,总生存率分别为90.3%和86.4%。差异无统计学意义。两组的复发率分别为10.6%和21.8%。在未进行放疗的情况下,2例患者出现盆腔复发;另外3例有远处转移。
结果表明,NAC后行手术加术后化疗但不放疗为IB2-IIB期宫颈癌的治疗提供了一种可行的选择。患者能够耐受化疗的副作用,且疗效较好。