Muderspach L I, Curtin J P, Roman L D, Gebhardt J A, Klement V, Qian D, Morrow C P, Felix J C, Formenti S C, Muggia F M
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles 90033, USA.
Gynecol Oncol. 1997 May;65(2):336-42. doi: 10.1006/gyno.1997.4647.
Radiation therapy is the mainstay in treatment of locally advanced cervical carcinoma. Several chemotherapeutic agents have been used as radiation sensitizers in the treatment of cervical cancer in an effort to improve local response and survival. A prospective study was designed to evaluate carboplatin as a radiosensitizer in advanced cervical cancer. Standard radiotherapy techniques were used to treat patients with Stage IIA-IIIB cervical cancer. Intravenous carboplatin was administered twice weekly concurrent with external beam radiation. Of 22 evaluable patients, there were 19 complete responders of whom 15 remain alive: 11 patients were alive and disease free at last visit for a median duration of 15 months follow-up (range, 4-43 months) and 4 patients remain alive with disease for a median duration of 17 months (range, 3-55 months). Seven have died, one of whom was without evidence of disease. There were no treatment-related deaths and no grade 4 toxicity. The most significant adverse effect was hematologic resulting in four patients with grade 3 neutropenia or anemia. There were no fistulae or late gastrointestinal or genitourinary complications. This pilot study suggests that carboplatin administered with standard radiation is safe, well-tolerated, and thus may be useful as a radiation sensitizer in the treatment of locally advanced cervical cancer.
放射治疗是局部晚期宫颈癌治疗的主要手段。几种化疗药物已被用作宫颈癌治疗中的放射增敏剂，以努力改善局部反应和生存率。一项前瞻性研究旨在评估卡铂作为晚期宫颈癌放射增敏剂的效果。采用标准放疗技术治疗IIA-IIIB期宫颈癌患者。静脉注射卡铂，每周两次，与外照射同步进行。在22例可评估患者中，有19例完全缓解，其中15例仍存活：11例患者在最后一次随访时存活且无疾病，中位随访时间为15个月（范围4-43个月），4例患者存活且有疾病，中位持续时间为17个月（范围3-55个月）。7例患者死亡，其中1例无疾病证据。无治疗相关死亡，无4级毒性反应。最显著的不良反应是血液学方面的，导致4例患者出现3级中性粒细胞减少或贫血。无瘘管形成，也无晚期胃肠道或泌尿生殖系统并发症。这项初步研究表明，卡铂与标准放疗联合使用是安全的，耐受性良好，因此可能作为局部晚期宫颈癌治疗中的放射增敏剂发挥作用。
