Document Detail


Usefulness of preoperative chemoradiation in locally advanced cervical carcinoma.
MedLine Citation:
PMID:  14671418     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study investigated response rate, toxicity, and influence on intra- and postoperative complications of neoadjuvant concurrent chemoradiation in locally advanced (Figo IB2-IIIB) cervical carcinomas. Twenty-eight patients (median age 46.5 years, age range 29-73 years), diagnosed as having squamous cell carcinomas (n=21), adenocarcinomas (n=6), and undifferentiated carcinoma (n=1), entered this study. The chemoradiation protocol included external radiotherapy to the pelvis (39.6 Gy), intra-arterial or intravenous infusion of cisplatin (70 mg/m2 on days 1 and 22), and 24-hour continuous intravenous infusion of 5-fluorouracil (700 mg/m2 on days 1-4 and 22-25). Two weeks after the end of chemoradiotherapy, the patients underwent restaging followed by suitable operation including pelvic lymphadenectomy. The median follow-up period in the surviving patients was 13.1 months. The response rate for chemoradiation was 93% (26/28). The 2-year disease free survival was 85.2%. Grade 3-4 neutropenia was observed in 14 patients (50%), 4 patients (14%) showed grade 3 anemia, and 5 patients (17.8%) showed grade 3-4 thrombocytopenia. Nineteen patients (67.8%) could undergo surgery after concurrent chemoradiation. Pathological examination revealed a complete response (pT0) in 7 patients, and 5 patients showed only microscopic residual disease (pTmic). In 4 patients, there were intraoperative complications: vesical lesions in 2 (10%) and small intestine lesions in 2 (10%). Neoadjuvant therapy with concurrent chemoradiation for locally advanced cervical carcinoma is effective, safe, and useful for increasing operability rates as well as decreasing intra- and postoperative complications. Therefore, neoadjuvant concurrent chemoradiation should be considered for treatment in patients with locally advanced cervical carcinomas who could not undergo primary operation.
Authors:
Kiyosumi Shibata; Fumitaka Kikkawa; Yuka Suzuki; Mikio Terauchi; Hiroaki Kajiyama; Kazuhiko Ino; Shigehiko Mizutani
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2003-12-09
Journal Detail:
Title:  Gynecologic and obstetric investigation     Volume:  57     ISSN:  0378-7346     ISO Abbreviation:  Gynecol. Obstet. Invest.     Publication Date:  2004  
Date Detail:
Created Date:  2004-01-30     Completed Date:  2004-08-11     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  7900587     Medline TA:  Gynecol Obstet Invest     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  93-9     Citation Subset:  IM    
Copyright Information:
Copyright 2004 S. Karger AG, Basel
Affiliation:
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. shiba@med.nagoya-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / pathology,  therapy*
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Carcinoma, Squamous Cell / pathology,  therapy*
Chemotherapy, Adjuvant
Cisplatin / administration & dosage
Disease-Free Survival
Female
Fluorouracil / administration & dosage
Humans
Middle Aged
Preoperative Care* / methods
Radiotherapy, Adjuvant
Treatment Outcome
Uterine Cervical Neoplasms / pathology,  therapy*
Chemical
Reg. No./Substance:
15663-27-1/Cisplatin; 51-21-8/Fluorouracil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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