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基于密集剂量紫杉醇和卡铂的新辅助化疗后行手术或同步放化疗治疗宫颈癌:初步分析

Dose-dense Paclitaxel- and Carboplatin-based Neoadjuvant Chemotherapy Followed by Surgery or Concurrent Chemo-radiotherapy in Cervical Cancer: a Preliminary Analysis.

作者信息

Gadducci Angiolo, Barsotti Cecilia, Laliscia Concetta, Cosio Stefania, Fanucchi Antonio, Tana Roberta, Fabrini Maria Grazia

机构信息

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.

出版信息

Anticancer Res. 2017 Mar;37(3):1249-1255. doi: 10.21873/anticanres.11441.

Abstract

AIM

To assess preliminary results with dose-dense neoadjuvant chemotherapy (NACT) prior to surgery or concurrent chemo-radiotherapy (CCRT) in cervical cancer.

PATIENTS AND METHODS

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).

RESULTS

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.

CONCLUSION

Dose-dense NACT seems to achieve promising RRs with manageable toxicity in cervical cancer. Investigation on larger series with longer follow-up is warranted.

摘要

目的

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。

患者与方法

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)。

结果

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。

结论

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。

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