Use of neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer: monitoring tumour shrinkage and molecular profile on magnetic resonance and assessment of 3-year outcome.
Use of neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer: monitoring tumour shrinkage and molecular profile on magnetic resonance and assessment of 3-year outcome.
复制标题
DOI：
10.1038/sj.bjc.6601870
复制
发表时间：
2004-06-14
影响因子：
8.8
通讯作者：
中科院分区：
文献类型：
--
作者：
本研究的目的是评估宫颈癌根治性子宫切除术前肿瘤对新辅助化疗的反应，使用磁共振（MR）监测肿瘤体积和分子谱的变化，并将其与对照组的生存率进行比较。入选条件包括Ib-IIb期既往未治疗的宫颈肿瘤bbb10 cm3。22例患者每周重复两次新辅助化疗（甲氨蝶呤300 mg m - 2（叶酸辅助），博来霉素30 mg m - 2，顺铂60 mg m - 2），共3个疗程，随后行根治性子宫切除术。术后放疗14例。在同一时间段内，共有23名接受根治性手术或放化疗的患者组成了非随机对照组。新辅助化疗前后和对照组的磁共振扫描记录了肿瘤体积的成像和体内光谱的代谢物。使用配对t检验比较变化。生存率采用Kaplan-Meier法计算。新辅助化疗组与对照组在年龄（平均，s.d分别为43.3±10、44.7±8.5岁，P=0.63）和肿瘤体积（中位数，四分位数分别为35.8、17.8、57.7 cm3 vs 23.0、15.0、37.0 cm3， P=0.068）方面无显著差异。化疗后肿瘤体积的减少（中位数，四分位数7.5,3.0,19.0 cm3）是显著的（P=0.002）。-CH2甘油三酯的降低接近显著性（P=0.05），但其他代谢物没有变化。化疗组3年生存率（49.1%）与对照组（46%，P=0.94）差异无统计学意义。新辅助化疗后肿瘤体积和-CH2甘油三酯水平显著降低，但没有生存优势。
The objective of this study is to assess tumour response to neoadjuvant chemotherapy prior to radical hysterectomy in cervical cancer using magnetic resonance (MR) to monitor tumour volume and changes in molecular profile and to compare the survival to that of a control group. Eligibility included Stage Ib–IIb previously untreated cervical tumours >10 cm3. Neoadjuvant chemotherapy in 22 patients (methotrexate 300 mg m−2 (with folinic acid rescue), bleomycin 30 mg m−2, cisplatin 60 mg m−2) was repeated twice weekly for three courses and followed by radical hysterectomy. Post-operative radiotherapy was given in 14 cases. A total of 23 patients treated either with radical surgery or chemoradiotherapy over the same time period comprised the nonrandomised control group. MR scans before and after neoadjuvant chemotherapy and in the control group documented tumour volume on imaging and metabolites on in vivo spectroscopy. Changes were compared using a paired t-test. Survival was calculated using the Kaplan–Meier method. There were no significant differences between the neoadjuvant chemotherapy and control groups in age (mean, s.d. 43.3±10, 44.7±8.5 years, respectively, P=0.63) or tumour volume (medians, quartiles 35.8, 17.8, 57.7 cm3 vs 23.0, 15.0, 37.0 cm3, respectively, P=0.068). The reduction in tumour volume post-chemotherapy (median, quartiles 7.5, 3.0, 19.0 cm3) was significant (P=0.002). The reduction in –CH2 triglyceride approached significance (P=0.05), but other metabolites were unchanged. The 3-year survival in the chemotherapy group (49.1%) was not significantly different from the control group (46%, P=0.94). There is a significant reduction in tumour volume and –CH2 triglyceride levels after neoadjuvant chemotherapy, but there is no survival advantage.
登录
查看更多内容
影响因子：
4.7
作者：
Aoki, Y;Tomita, M;Tanaka, K
通讯作者：
Tanaka, K
影响因子：
3.4
作者：
Cromheecke, M;Piers, BA;Hoekstra, HJ
通讯作者：
Hoekstra, HJ
影响因子：
45.3
作者：
Chang, TC;Lai, CH;Soong, YK
通讯作者：
Soong, YK
影响因子：
2.5
作者：
Vigneron, D;Bollen, A;Nelson, S
通讯作者：
Nelson, S
影响因子：
5
作者：
deSouza, NM;Scoones, D;Soutter, WP
通讯作者：
Soutter, WP