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回顾性研究多西他赛/卡铂联合治疗作为非鳞状细胞宫颈癌术后辅助化疗的疗效和安全性。

Retrospective study of the efficacy and safety of docetaxel/carboplatin combination therapy as postoperative adjuvant chemotherapy for nonsquamous cell carcinoma of the cervix.

机构信息

Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.

Department of Gynecologic Oncology, Cancer Institute hospital of JFCR, Tokyo, Japan.

出版信息

Int J Clin Oncol. 2023 Oct;28(10):1421-1430. doi: 10.1007/s10147-023-02392-0. Epub 2023 Aug 16.

Abstract

OBJECTIVE

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).

METHODS

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).

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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)。

结果

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。

结论

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。

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