Small Cell Carcinoma of the Uterine Cervix: Clinical Outcome of Concurrent Chemoradiotherapy with a Multidrug Regimen
Small Cell Carcinoma of the Uterine Cervix: Clinical Outcome of Concurrent Chemoradiotherapy with a Multidrug Regimen
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DOI：
10.1620/tjem.229.75
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发表时间：
2013-01-01
影响因子：
2.2
通讯作者：
Yaegashi, Nobuo
中科院分区：
文献类型：
--
作者：
Tokunaga, Hideki;Nagase, Satoru;Yaegashi, Nobuo
子宫颈小细胞癌（SCCC）是一种罕见的宫颈癌亚型，具有侵袭性。尽管SCCC的预后比其他组织学类型的宫颈癌（如鳞状细胞癌或腺癌）差，但由于其罕见性，SCCC的标准治疗仍有待建立。本研究的目的是评价同步放化疗（CCRT）的疗效和毒性，采用长春新碱、阿霉素和环磷酰胺交替顺铂和依托泊苷（VAC/PE）方案。我们分析了9例SCCC患者。5例IB期疾病患者接受了根治性子宫切除术，随后接受了CCRT。4例晚期患者接受了CCRT。中位随访时间为47.4个月（范围：10.5 - 86.4个月），5例IB期疾病患者中有4例存活，无复发。4例晚期患者的缓解率为75%（完全缓解，1例;部分缓解，2例;疾病进展，1例）。1例IVB期患者89.5个月未复发。5年时，所有患者的总生存率（OS）和无进展生存率分别为52%和56%。早期疾病患者的5年OS率为80%，而晚期疾病患者的5年OS率为25%。尽管所有患者均发生了3-4级中性粒细胞减少，但使用VAC/PE的CCRT在SCCC的主要和辅助环境中均是可行的。特别是，这种综合疗法可以改善局部控制和生存的早期疾病患者的术后治疗。
Small cell carcinoma of the uterine cervix (SCCC) is a rare subtype of cervical cancer with an aggressive behavior. Although SCCC has a worse prognosis than other histological types of uterine cervical cancer such as squamous cell carcinoma or adenocarcinoma, standard therapy for SCCC remains to be established due to its rarity. The purpose of this study was to evaluate the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) using a regimen consisting of vincristine, adriamycin, and cyclophosphamide alternating with cisplatin and etoposide (VAC/PE). We analyzed a series of 9 patients with SCCC. Five patients with stage IB disease underwent radical hysterectomy followed by CCRT. Four patients with advanced stage disease received CCRT primarily. With a median follow-up duration of 47.4 months (range, 10.5 to 86.4 months), 4 out of 5 patients with stage IB disease were alive without recurrence. In 4 patients with advanced stage disease, the response rate was 75% (complete response, 1; partial response, 2; progressive disease, 1). One patient with stage IVB disease remained without recurrence for 89.5 months. At 5 years, overall survival (OS) and progression-free survival for all patients was 52% and 56%, respectively. Patients with early-stage disease had an 80% 5-year OS rate compared to 25% for patients with advanced stage disease. Although all patients developed grade 3-4 neutropenia, CCRT using VAC/PE is feasible in both the primary and adjuvant settings for SCCC. In particular, this combined modality therapy may improve both local control and survival as postoperative treatment in patients with early-stage disease.