Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
Department of Gynecologic Oncology, Cancer Institute hospital of JFCR, Tokyo, Japan.
Int J Clin Oncol. 2023 Oct;28(10):1421-1430. doi: 10.1007/s10147-023-02392-0. Epub 2023 Aug 16.
Optimal adjuvant chemotherapy for nonsquamous cervical carcinoma has not yet been established. This study investigated the efficacy and safety of docetaxel/carboplatin (DC) for early-stage nonsquamous cell cervical carcinoma after radical hysterectomy (RH).
We evaluated 157 patients with stage IB-IIB nonsquamous cervical carcinoma with intermediate risk and high risk treated at our institution with DC after type II or III RH from 2007 to 2021. Patients received docetaxel (60-70 mg/m) and carboplatin (area under the curve 5-6) every 3 weeks for six cycles. The primary endpoint was 2 year recurrence-free survival (RFS) and the secondary endpoint was adverse events (AEs).
There were 106 intermediate-risk and 51 high-risk patients. The high-risk patients included 11 with positive parametrial involvement, 20 with pelvic lymph node metastases, and 20 with both parametrial involvement and pelvic lymph node metastases. The 2 year RFS rates for intermediate-risk, high-risk, and positive pelvic lymph nodes were 94.8% (95% confidence interval [CI], 87.9-97.8), 80.1% (95% CI, 64.1-89.5), and 74.5% (95% CI, 55.4-86.4), respectively. Sixteen patients had recurrence, including local recurrence (n = 6), distant metastasis (n = 9), and local and distant metastasis (n = 1). Hematologic toxicity was the most frequent AE, especially leukopenia and neutropenia. Nausea and constipation were the most frequent nonhematologic toxicities.
DC therapy at our institution showed good 2 year RFS, and postoperative adjuvant therapy with DC therapy is suggested as a useful strategy for patients with nonsquamous cervical carcinoma.
非鳞状宫颈癌的最佳辅助化疗尚未确定。本研究探讨了根治性子宫切除术后(RH)接受多西他赛/卡铂(DC)治疗的中危和高危早期非鳞状细胞宫颈癌的疗效和安全性。
我们评估了 2007 年至 2021 年在我院接受 II 型或 III 型 RH 后接受 DC 治疗的中危和高危、IB-IIB 期非鳞状宫颈癌患者 157 例。患者每 3 周接受多西他赛(60-70mg/m)和卡铂(曲线下面积 5-6)治疗 6 个周期。主要终点是 2 年无复发生存率(RFS),次要终点是不良事件(AE)。
中危患者 106 例,高危患者 51 例。高危患者包括 11 例宫旁受累阳性、20 例盆腔淋巴结转移、20 例宫旁受累和盆腔淋巴结转移。中危、高危和盆腔淋巴结阳性患者的 2 年 RFS 率分别为 94.8%(95%置信区间 [CI],87.9-97.8)、80.1%(95% CI,64.1-89.5)和 74.5%(95% CI,55.4-86.4)。16 例患者复发,包括局部复发(n=6)、远处转移(n=9)和局部和远处转移(n=1)。血液学毒性最常见,尤其是白细胞减少和中性粒细胞减少。恶心和便秘是最常见的非血液学毒性。
本研究中 DC 治疗显示出良好的 2 年 RFS,术后辅助 DC 治疗被认为是治疗非鳞状宫颈癌患者的一种有效策略。