DOSE-INTENSIVE NEOADJUVANT CHEMOTHERAPY IN COMBINED TREATMENT FOR LOCALLY ADVANCED CERVICAL CANCER: THE EXPERIENCE AND PERSPECTIVES

2017 ◽  
Vol 63 (4) ◽  
pp. 614-621
Author(s):  
Igor Berlev ◽  
Yekaterina Nekrasova ◽  
Gayk Mkrtchyan ◽  
Yevgeniya Bezhanova ◽  
Katran Guseynov ◽  
...  

In 24 patients (mean age 48 years) with locally advanced cervical cancer there were studied the efficacy and toxicity of 3 cycles of neoadjuvant dose-intensive chemotherapy with cisplatin (75 mg/m2) and doxorubicin (35 mg/m2) administered intravenously on the first day of a two- week cycle with the support of colony-stimulating factors. An important criterion for the inclusion in this study of patients with locally advanced cervical cancer (T1b2-2bN0-1M0) was the absence of infiltration of the anterior parameters according to the gynecological examination and MRI studies. An objective response to treatment was registered in 72.7 % of cases. Progression of the disease was not detected in any case. Conducting neoadjuvant drug therapy allowed performing radical surgical intervention in 95.4 % of patients. The pathomorphlogical response of tumor of varying severity was 40.9 %. In 9.1 % complete clinical regression of tumor was confirmed by a complete pathomor-phological response (CR). The dose-intensive regimen of chemotherapy did not lead to a significant increase of complications on the drug and surgical stages. An analysis showed that dose-intensive neoadjuvant chemotherapy is a highly effective method in treatment for locally advanced cervical cancer.

2019 ◽  
Vol 14 (4) ◽  
pp. 56-64
Author(s):  
O. A. Smirnova ◽  
N. E. Bondarev ◽  
E. A. Ulrikh ◽  
N. A. Mikaya ◽  
A. S. Petrova ◽  
...  

Objective:to assess the efficacy of dose-intensive platinum-containing neoadjuvant chemotherapy in patients with FIGO stage IB2–IIB locally advanced cervical cancer.Materials and methods.We evaluated the efficacy and toxicity of 3 cycles of intravenous dose-intensive neoadjuvant chemotherapy with either AP regimen (cisplatin 75 mg/m2 and doxorubicin 35 mg/m2) or TP regimen (cisplatin 60 mg/m2 and paclitaxel 60 mg/m2).Results.The study included 105 patients (75 in the AP group and 30 in the TP group) aged between 27 and 63 years (mean age 44 years) with primary verified cervical cancer (T1–2B0–2Nx–0M0). Surgery was performed in 66 patients (88 %) from the AP group and 24 patients (80 %) from the TP group. Six patients (8 %) receiving AP regimen and 1 patient (3.3 %) receiving TP regimen developed disease progression. Four women (2.8 %) from the AP group developed relapses, whereas none of the patients from the TP group had relapses. Dose-intensive chemotherapy did not cause any significant complications at both chemotherapeutic and surgical stages. Our findings suggest that dose-intensive neoadjuvant chemotherapy is an effective method with an objective response rate of 84 % (63 cases) and 56.7 % (17 cases) in groups AP and TP respectively. Fifty-nine patients (78.7 %) receiving AP regimen had pathological response; of them, 7 participants (9.4 %) demonstrated pathological complete response (ypCR). In the TP group, 19 patients (63.3 %) had pathological response and 4 patients (13.4 %) had pathological complete response. Median follow-up time was 16.7 months (range: 3–29 months) in the AP group and 9.1 months (range: 2.8–12.7 months) in the TP group.Conclusion.Dose-intensive neoadjuvant chemotherapy can be considered as an alternative to standard treatment of locally advanced cervical cancer; however, further studies are needed due to the small sample size in this study.


2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Antonios Athanasiou ◽  
Sarah J Bowden ◽  
Evangelos Paraskevaidis ◽  
T S Shylasree ◽  
Kostas Lathouras ◽  
...  

1994 ◽  
Vol 12 (11) ◽  
pp. 2309-2316 ◽  
Author(s):  
G Scambia ◽  
P Benedetti Panici ◽  
E Foti ◽  
M Amoroso ◽  
G Salerno ◽  
...  

PURPOSE The aim of the study was to investigate the role of squamous cell carcinoma antigen (SCC) in the management of patients with locally advanced cervical cancer treated by neoadjuvant chemotherapy and radical surgery. PATIENTS AND METHODS SCC assay was performed with a radioimmunoassay kit in a series of 102 patients with locally advanced cervical cancer. The values of 2.5, 5, and 7 ng/mL were used to define SCC antigen positivity. The chi 2 and Fisher's exact test and the stepwise logistic regression were used to evaluate the distribution of marker values. Analysis of survival was performed using the Kaplan and Meier test and Cox multivariate regression analysis. RESULTS SCC levels were elevated in 65%, 45%, and 32% of patients with primary tumors for cutoff values of 2.5, 5, and 7 ng/mL, respectively. SCC pretreatment levels correlated with stage, tumor volume and lymph node status. In the multivariate analysis, SCC expression proved to be an independent predictor of response to neoadjuvant chemotherapy. SCC posttreatment levels were strongly related to chemotherapy response. Moreover, the overall correlation between the clinical course of the disease and the variation of SCC levels was 83%. In patients with squamous cell tumors, survival was significantly longer in SCC-negative cases compared with SCC-positive cases (P = .04). Moreover, in patients undergoing surgery after response to neoadjuvant chemotherapy, low SCC values were associated with better prognosis (P = .02). In the multivariate analysis, parametrial involvement and SCC status proved to retain an independent prognostic value. CONCLUSION Our data show that SCC assay may provide useful information to improve the prognostic characterization and disease monitoring of patients with locally advanced cervical cancer undergoing neoadjuvant chemotherapy.


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