CONCURRENT CHEMORADIOTHERAPY WITH PACLITAXEL AND NEDAPLATIN FOLLOWED BY CONSOLIDATION CHEMOTHERAPY IN LOCALLY ADVANCED SQUAMOUS CELL CARCINOMA OF THE UTERINE CERVIX: PRELIMINARY RESULTS OF A PHASE II STUDY
CONCURRENT CHEMORADIOTHERAPY WITH PACLITAXEL AND NEDAPLATIN FOLLOWED BY CONSOLIDATION CHEMOTHERAPY IN LOCALLY ADVANCED SQUAMOUS CELL CARCINOMA OF THE UTERINE CERVIX: PRELIMINARY RESULTS OF A PHASE II STUDY
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DOI：
10.1016/j.ijrobp.2009.08.069
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发表时间：
2010-11-01
影响因子：
7
通讯作者：
Wang, Xiang-E
中科院分区：
文献类型：
--
作者：
Zhang, Mei-Qin;Liu, Su-Ping;Wang, Xiang-E
用途：评价同步放化疗（CCRT）和巩固化疗治疗局部晚期宫颈鳞癌的疗效和毒副反应。LASCC患者（FIGO IIB-IIIB期）接受盆腔外照射放疗（IIB期45戈伊，III期50戈伊）和高剂量率腔内近距离放射治疗（HE期50戈伊，III期35戈伊）。IIB期A点的累积剂量为50戈伊，III期为65戈伊。化疗方案为紫杉醇35 mg/m2+奈达铂20 mg/m2，每周1次，共6周。紫杉醇（135 mg/m2）和奈达铂（60 mg/m2）每3周给予一次巩固化疗，持续4个周期。结果：所有患者均完成CCRT，34例患者中28例完成巩固化疗。完全缓解率为88%（95% CI，73-96%）。最常见的3级或以上毒性为白细胞减少症/中性粒细胞减少症（10.9%的周期）。在中位随访23个月（范围，14-30个月）期间，5例患者出现局部失败，1例患者出现远处转移。估计的2年无进展生存期和总生存期分别为82%（95% CI，68-95%）和93%（95% CI，83-100%）。3例患者（9%）发生3级晚期并发症。结论：紫杉醇和奈达铂联合CCRT联合巩固化疗对局部晚期宫颈鳞状细胞癌患者耐受性良好且有效。值得进行进一步的随机试验，比较这种方案与标准治疗。(C)2010年爱思唯尔公司
Purpose: To evaluate the efficacy and toxicities of concurrent chemoradiotherapy (CCRT) and consolidation chemotherapy in patients with locally advanced squamous cell cervical carcinoma.Methods and Materials: Patients with LASCC (FIGO Stage IIB-IIIB) were treated with pelvic external beam radiotherapy (45 Gy for Stage IIB and 50 Gy for Stage III) and high-dose-rate intracavitary brachytherapy (50 Gy for Stage HE and 35 Gy for Stage III). The cumulative dose at point A was 50 Gy for Stage IIB and 65 Gy for Stage III. Concurrent chemotherapy with paclitaxel (35 mg/m(2)) and nedaplatin (20 mg/m(2)) was given every week for 6 weeks. Consolidation chemotherapy with paclitaxel (135 mg/m(2)) and nedaplatin (60 mg/m(2)) was administered every 3 weeks for 4 cycles.Results: All patients completed CCRT, and 28 of 34 patients completed consolidation chemotherapy. The complete response rate was 88% (95% CI, 73-96%). The most common Grade 3 or higher toxicities were leukopenia/neutropenia (10.9% of the cycles). During a median follow up of 23 months (range, 14-30 months), 5 patients had locoregional failure and 1 patient had distant metastasis. The estimated 2-year progression-free survival and overall survival were 82% (95% CI, 68-95%) and 93% (95% CI, 83-100%), respectively. Grade 3 late complications occurred in 3 patients (9%).Conclusions: CCRT with paclitaxel and nedaplatin followed by consolidation chemotherapy is well tolerated and effective in patients with locally advanced squamous cell cervical carcinoma. Further randomized trials of comparing this regimen with the standard treatment are worth while. (C) 2010 Elsevier Inc.