Gadducci Angiolo, Barsotti Cecilia, Laliscia Concetta, Cosio Stefania, Fanucchi Antonio, Tana Roberta, Fabrini Maria Grazia
Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy
Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Pisa, Italy.
Anticancer Res. 2017 Mar;37(3):1249-1255. doi: 10.21873/anticanres.11441.
To assess preliminary results with dose-dense neoadjuvant chemotherapy (NACT) prior to surgery or concurrent chemo-radiotherapy (CCRT) in cervical cancer.
Thirty patients received weekly paclitaxel (80 mg/m) plus carboplatin (AUC2) for 6 cycles followed by radical hysterectomy in 16 (stage Ib-IIb), conisation in one (stage Ib1), and CCRT in 13 (stage Ib-IIb). Median follow-up of survivors was 12 months (range=3-22).
Among the surgically treated patients, clinical overall response rate (RR) was 82.3%, optimal pathological RR was 17.6%, and suboptimal pathological RR with intra-cervical residual disease was 41.2%. Only one patient relapsed. Among the CCRT treated patients, partial RR after NACT was 76.9% and complete RR after CCRT was 58.3%. However, 42.8% of complete responders recurred. Toxicity was acceptable.
Dose-dense NACT seems to achieve promising RRs with manageable toxicity in cervical cancer. Investigation on larger series with longer follow-up is warranted.
评估在宫颈癌手术或同步放化疗（CCRT）之前采用剂量密集新辅助化疗（NACT）的初步结果。
30例患者接受每周一次的紫杉醇（80mg/m）加卡铂（AUC2）治疗，共6个周期，随后16例（Ib-IIb期）接受根治性子宫切除术，1例（Ib1期）接受锥切术，13例（Ib-IIb期）接受CCRT。幸存者的中位随访时间为12个月（范围=3-22个月）。
在接受手术治疗的患者中，临床总缓解率（RR）为82.3%，最佳病理RR为17.6%，宫颈内有残留病灶的次优病理RR为41.2%。仅1例患者复发。在接受CCRT治疗的患者中，NACT后的部分RR为76.9%，CCRT后的完全RR为58.3%。然而，42.8%的完全缓解者复发。毒性是可接受的。
剂量密集NACT在宫颈癌中似乎能取得有前景的RR，且毒性可控。有必要对更大样本量且随访时间更长的系列进行研究。
