Long-term follow-up of neoadjuvant cisplatin and 5-fluorouracil chemotherapy in bulky squamous cell carcinoma of the cervix
Long-term follow-up of neoadjuvant cisplatin and 5-fluorouracil chemotherapy in bulky squamous cell carcinoma of the cervix
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DOI：
10.1080/028418699432077
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发表时间：
1999-01-01
期刊：
影响因子：
3.1
通讯作者：
Tropé, C
中科院分区：
文献类型：
--
作者：
Marth, C;Sundfor, K;Tropé, C
1 - 5例巨大（最大直径>3 cm）FIGO Ib或IIa期宫颈鳞癌患者在计划行根治性子宫切除术前接受顺铂（100 mg/m2，第1天）和5-氟尿嘧啶（1000 mg/m2，连续第1-5天）静脉给药，间隔21天，共2或3个疗程。在4名患者中观察到完全临床应答，在10名患者中观察到部分应答：这代表了93%的总体应答率。1例患者病情稳定（两个疗程化疗），无患者病情进展。诊断时和新辅助化疗后的中位肿瘤体积分别为78.5 cm（3）和2.5 cm（3）（p < 0.001）。这表明化疗导致肿瘤体积减少了97%。中位总生存期和无病生存期没有达到，精算的5年生存率分别为73%和67%。无4级毒性，骨髓抑制可接受;然而。两名患者出现明显的耳毒性，两名患者的血清肌酐升高。所有出现严重毒性反应的患者仅接受两个周期的化疗。本研究中局部控制和生存率的改善与其他报道的结果一致，但需要在随机前瞻性试验中证实。
Fifteen patients with bulky (designated as >3 cm largest diameter) FIGO stage Ib or IIa squamous cervical cancer were treated with cisplatin (100 mg/m(2) on day 1) and 5-fluorouracil (1000 mg/m(2) continuously on days 1-5) administered intravenously at 21-day intervals for a total of two or three courses before planned radical hysterectomy. A complete clinical response was noted in four patients and a partial response in ten patients: which represents a 93% overall response rate. One patient had stable disease (two courses of chemotherapy), and none had progressive disease. Median tumor volume was 78.5 cm(3) and 2.5 cm(3) at diagnosis and after neoadjuvant chemotherapy, respectively (p < 0.001). This indicates that chemotherapy resulted in a 97% median reduction of tumor volume. Median overall and disease-free survival was not reached, and the actuarial five-year survival rate was 73% and 67%, respectively. There was no grade 4 toxicity, Myelosuppression was acceptable; however. two patients experienced significant ototoxicity, and in two patients serum creatinine increased. All patients with major toxicity received two cycles of chemotherapy only. The improved local control and survival in our series are in accordance with other results reported, but need to be confirmed in a randomized prospective trial.