Onishi Y, Hatae M, Hokanishi H
Department of Obstetrics and Gynecology, Kagoshima Municipal Hospital.
Nihon Sanka Fujinka Gakkai Zasshi. 1993 Jul;45(7):657-64.
Twenty seven patients with cervical cancer were treated with PVP therapy including cisplatin 50mg/m2, vinblastine 4mg/m2 and peplomycin 15mg/body during the period from 1984 to 1989. Fourteen patients had a primary lesion. Five of 14 patients were treated with PVP as the primary therapy because of pathological findings which suggested no radiotherapy effect. Nine patients had a radio-resistant lesion and were treated following PVP. Twelve of 14 cases responded and median survival time was 32.5 months (2-101 months). Thirteen patients were treated with PVP because of recurrent cervical cancer. Five of those which recurred after radiotherapy and other 8 cases had been treated with radical hysterectomy and radiotherapy. Two of 5 cases with previous radiotherapy responded and one of 2 patient is still alive with no evidence of disease, but the patients treated with radical hysterectomy and pelvic irradiation showed no sign of a PVP effect and all of them died within 1 year. Primary cases responded even after radiation and some are still alive after more than 5 years. But PVP had no effect on the in patients which there was recurrence. It is necessary to determine which regimen is better, how to select the dose of cisplatin and how to combine the chemotherapy and other therapy. Patients who responded survived for a long time and PVP is an effective therapy. To obtain a better prognosis for advanced cervical cancer, we need a prospective randomized study of radio-chemotherapy or chemo-radiotherapy.
1984年至1989年期间,27例宫颈癌患者接受了PVP疗法,该疗法包括顺铂50mg/m²、长春碱4mg/m²和培普利欧霉素15mg/人。14例患者有原发性病变。14例患者中有5例因病理结果提示放疗无效而接受PVP作为主要治疗方法。9例患者有放疗抵抗性病变,在PVP治疗后接受治疗。14例患者中有12例有反应,中位生存时间为32.5个月(2至101个月)。13例患者因复发性宫颈癌接受PVP治疗。其中5例放疗后复发,另外8例曾接受根治性子宫切除术和放疗。5例曾接受放疗的患者中有2例有反应,2例患者中有1例仍存活且无疾病证据,但接受根治性子宫切除术和盆腔照射的患者未显示PVP治疗效果迹象,所有患者均在1年内死亡。原发性病例即使在放疗后也有反应,一些患者在5年多后仍存活。但PVP对复发患者无效。有必要确定哪种方案更好,如何选择顺铂剂量以及如何联合化疗和其他治疗方法。有反应的患者存活时间长,PVP是一种有效的治疗方法。为了使晚期宫颈癌获得更好的预后,我们需要对放化疗或化疗放疗进行前瞻性随机研究。