Neoadjuvant intraarterial infusion chemotherapy in patients with stage IB2-IIIB cervical cancer
Neoadjuvant intraarterial infusion chemotherapy in patients with stage IB2-IIIB cervical cancer
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DOI：
10.1006/gyno.2000.5730
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发表时间：
2000-05-01
影响因子：
4.7
通讯作者：
Saito, S
中科院分区：
文献类型：
--
作者：
Yamakawa, Y;Fujimura, M;Saito, S
目标。本研究的目的是确定新辅助动脉内化疗（NAIC）对局部晚期宫颈癌患者预后的影响。方法。从1992年1月到1997年12月，26名先前未经治疗的1B2-IIIB期宫颈癌患者被纳入该研究。 NAIC 每 3 周使用 17.5 mg/m(2) 博来霉素、7 mg/m(2) 丝裂霉素-C 和 75 mg/m(2) 顺铂的组合通过双侧髂内动脉施用两个疗程以上。通过手术标本的组织学检查评估病理结果。采用1980年至1991年间接受常规治疗的120名患者组成的非随机对照组进行比较。结果。 26 名患者中有 19 名 (73.1%) 对初始化疗有反应，其中 14 名患者允许接受根治性子宫切除术和盆腔淋巴结切除术。其余5名患者接受了放射治疗。 7 名无反应者中的一名能够接受根治性手术。 15 名接受根治性手术的患者中有 4 名发现病理完全缓解。 15例接受NAIC后行根治性手术的患者淋巴结转移、宫旁浸润和血管间隙受累的发生率显着低于对照组（13.3%、6.7%和13.3% vs 54.2%、43.8%和60.4%）。所有 26 名接受 NAIC 治疗的患者的总体 5 年估计生存率 (80.0%) 显着高于对照组 (59.6%)。在II期和III期，接受NAIC治疗的患者5年生存率显着高于对照组（83.3%和77.8% vs 68.1%和49.8%）。结论。这些初步结果表明，NAIC能够有效消除盆腔内的病理危险因素，提高不能手术的IIIB期宫颈癌患者的可手术性，改善局部晚期宫颈癌患者的预后。 (C) 2000 年学术出版社。
Objectives. The purpose of this study was determine the effect of neoadjuvant intraarterial chemotherapy (NAIC) on the prognosis of patients with locally advanced cervical cancer.Methods. From January 1992 to December 1997, 26 previously untreated patients with stage 1B2-IIIB cervical cancer were enrolled in the study. NAIC was administered for more than two courses every 3 weeks using a combination of 17.5 mg/m(2) bleomycin, 7 mg/m(2) mitomycin-C, and 75 mg/m(2) cisplatin via the bilateral internal iliac artery. Pathologic findings were evaluated with histologic examinations of surgical specimens. A nonrandomized control group of 120 patients who underwent conventional treatment between 1980 and 1991 was used for comparison.Results. Nineteen (73.1%) of the 26 patients responded to initial chemotherapy, permitting a radical hysterectomy with pelvic lymphadenectomy in 14 patients. The remaining 5 patients received radiotherapy. One of 7 nonresponders was able to undergo radical surgery. Pathologic complete responses were found in 4 of the 15 patients who underwent radical surgery. The incidence of lymph node metastasis, parametrial infiltration, and vascular space involvement in the 15 patients who received NAIC followed by radical surgery was significantly lower than that in the control group (13.3, 6.7, and 13.3% vs 54.2, 43.8, and 60.4%). The overall 5-year estimated survival rate was significantly higher for all 26 patients who received NAIC (80.0%) than for the control group (59.6%). In stage II and III, the 5-year survival rate for patients who received NAIC was significantly higher than that in the control group (83.3 and 77.8% vs 68.1 and 49.8%).Conclusions. These preliminary results suggest that NAIC is able to eliminate effectively the pathologic risk factors in the pelvic cavity, to improve the operability in patients with stage IIIB cervical cancer, considered inoperable, and to improve the prognosis of patients with locally advanced cervical cancer. (C) 2000 Academic Press.