Abstract
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.
Highlights
Objective: to assess the efficacy of dose-intensive platinum-containing neoadjuvant chemotherapy in patients with FIGO stage IB2–IIB locally advanced cervical cancer
We evaluated the efficacy and toxicity of 3 cycles of intravenous dose-intensive neoadjuvant chemotherapy with either AP regimen or TP regimen
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
Summary
Цель исследования – оценить результаты применения неоадъювантной дозоинтенсивной платиносодержащей химиотерапии у больных местно-распространенной формой рака шейки матки IВ2–IIВ стадии по классификации FIGO. В исследование было включено 105 первичных больных (75 – в группе АР, 30 – в группе ТР) в возрасте 27–63 лет (средний возраст – 44 года) с верифицированным раком шейки матки (T1–2B0–2Nx–0M0). Что дозоинтенсивная неоадъювантная химиотерапия является эффективным методом с частотой объективного ответа 84 % (63 случая) в группе АР и 56,7 % в группе ТР (17 случаев). Дозоинтенсивная неоадъювантная химиотерапия может быть рассмотрена как альтернатива стандартному лечению местно-распространенного рака шейки матки, что требует дальнейшего изучения ввиду малого числа наблюдений. Ключевые слова: местно-распространенный рак шейки матки, дозоинтенсивная неоадъювантная химиотерапия, цисплатин, патоморфологический ответ. Для цитирования: Смирнова О.А., Бондарев Н.Э., Ульрих Е.А. Оценка эффективности неоадъювантной дозоинтенсивной платиносодержащей химиотерапии в комбинированном лечении местно-распространенного рака шейки матки. Surgery was performed in 66 patients (88 %) from the AP group and 24 patients
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