Clinical efficacy and safety of neo-adjuvant chemotherapy for stageⅠB2-ⅡB cervical cancer _West China Medical Journal

Authors：

 WAN Xiaoli , REN Wangjing , LIAO Yun , TANG Qi , PENG Yingchun

Department of Gynaecology, the People’s Hospital of Leshan, Leshan, Sichuan 614000, P. R. China;

Corresponding author：

WAN Xiaoli, Email: 82208064@qq.com

Keywords：

Neo-adjuvant chemotherapy; Cervical cancer; Surgical treatment; Efficacy; Adverse reaction

DOI：

10.7507/1002-0179.201611069

Video：

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Objective To investigate the efficacy and safety of neo-adjuvant chemotherapy for stage Ⅰ_B2-Ⅱ_B cervical cancer. Methods From June 2012 to December 2014, 66 patients with stage Ⅰ_B2-Ⅱ_B cervical cancer were selected and treated by PT (cisplatin/ carboplatin and taxol/docetaxel) as neo-adjuvant chemotherapy prior to surgery. Neo-adjuvant chemotherapy response and toxicity were collected and analyzed. Results The extinctive condition of tumor by neo-adjuvant chemotherapy: the complete remission rate was 10.6% (7/66), partial remission rate was 59.1% (39/66), and the total effective rate was 69.7%. The main toxicities were myelosuppression (59.1%, 39/66) and gastrointestinal reactions (33.3%, 22/66). The toxicities could be tolerated or relieved by prevention and treatment. The effective rate of chemotherapy for cervical squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma was 72.6%, 33.3% and 0%, respectively, with significant differences among the three types (P<0.05). The effective rate of chemotherapy for high, medium and low differentiated cervical cancer was 100.0%, 77.3% and 55.9%, respectively, with significant differences among the three degrees (P<0.05). Conclusions Neo-adjuvant chemotherapy is proved to be a safe and effective complementary treatment for most patients with locally advanced cervical cancer. Due to the limitation of sample size, the correlations between therapeutic effect and tumor differentiation degree and between therapeutic effect and pathological type need further study.

Citation： WAN Xiaoli, REN Wangjing, LIAO Yun, TANG Qi, PENG Yingchun. Clinical efficacy and safety of neo-adjuvant chemotherapy for stageⅠ_B2-Ⅱ_B cervical cancer . West China Medical Journal, 2017, 32(10): 1533-1538. doi: 10.7507/1002-0179.201611069 Copy

1.	Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2): 69-90.
2.	Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin, 2005, 55(2): 74-108.
3.	Zhou J, Li X, Huang K, et al. Young cervical cancer patients may be more responsive than older patients to neoadjuvant chemotherapy followed by radical surgery. PLoS One, 2016, 11(2): e0149534.
4.	Tewari KS, Sill MW, Long IH, et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med, 2014, 370(8): 734-743.
5.	Rein DT, Kurbacher CM, Breidenbach M, et al. Weekly carboplatin and docetaxel for locally advanced primary and recurrent cervical cancer: a phase Ⅰ study. Gynecol Oncol, 2002, 87(1): 98-103.
6.	何超蔓, 陈曼玲, 黎明鸾, 等. 宫颈癌新辅助化疗的临床初步观察. 海南医学院学报, 2009, 15(7): 764-766.
7.	Micheletti E, La Face B, Bianchi E, et al. Continuous infusion of carboplatin during conventional radiotherapy treatment in advanced squamous carcinoma of the cervix uteri Ⅱ<sub>B</sub>-Ⅲ<sub>B</sub> (UICC). A phase Ⅰ/Ⅱ and pharmacokinetic study. Am J Clin Oncol, 1997, 20(6): 613-620.
8.	曹泽毅. 妇科常见肿瘤诊治指南. 3 版. 北京: 人民卫生出版社, 2012: 129-131.
9.	Ferrandina G, Carbone A, Macchia G, et al. A complete pathological response to treatment in a young patient with locally advanced minimal deviation adenocarcinoma of the uterine cervix undergoing chemoradiation followed by radical surgery. Gynecol Obstet Invest, 2011, 72(2): 141-144.
10.	黄清华, 李力. 宫颈癌新辅助化疗临床研究现状. 国际妇产科学杂志, 2009, 36(5): 380-383.
11.	Iwata T, Miyauchi A, Suga Y, et al. Neoadjuvant chemotherapy for locally advanced cervical cancer. Chin J Cancer Res, 2016, 28(2): 235-240.
12.	De Azevedo CR, Thuler LC, De Mello MJ, et al. Neoadjuvant chemotherapy followed by chemoradiation in cervical carcinoma: a review. Int J Gynecol Cancer, 2016, 26(4): 729-736.
13.	Lapresa M, Parma G, Portuesi R, et al. Neoadjuvant chemotherapy in cervical cancer: an update. Expert Rev Anticancer Ther, 2015, 15(10): 1171-1181.
14.	Ye Q, Yuan HX, Chen HL. Responsiveness of neoadjuvant chemotherapy before surgery predicts favorable prognosis for cervical cancer patients: a meta-analysis. J Cancer Res Clin Oncol, 2013, 139(11): 1887-1898.
15.	Yang L, Guo J, Shen Y, et al. Clinical efficacy and safety of paclitaxel plus caoplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage Ⅰ<sub>B2</sub>-Ⅱ<sub>B</sub> cervical cancer. Int J Clin Exp Med, 2015, 8(8): 13690-13698.
16.	Kim HS, Sardi JE, Katsumata N, et al. Efficacy of neoadjuvant chemotherapy in patients with FIGO stage ⅠB1 to ⅡA cervical cancer: an international collaborative meta-analysis. Eur J Surg Oncol, 2013, 39(2): 115-124.
17.	Basile S, Angioli R, Manci N, et al. Gynecological cancers in developing countries: the challenge of chemotherapy in low-resources setting. Int J Gynecol Cancer, 2006, 16(4): 1491-1497.
18.	Rydzewska L, Tierney J, Vale CL, et al. Neoadjuvant chemotherapy plus surgery <italic>versus</italic> surgery for cervical cancer. Cochrane Database Syst Rev, 2010(1): CD007406.
19.	王毅军, 蒋本贵. 不同方法治疗 Ⅰb<sub>2</sub>-Ⅱa<sub>2</sub> 期巨块型宫颈癌的疗效观察. 武汉大学学报: 医学版, 2014, 35(4): 620-623.
20.	曲思娆, 武昕, 赵晶, 等. 单纯放疗、新辅助化疗及同步放化疗治疗宫颈癌临床近期疗效比较. 中国实用妇科与产科杂志, 2010, 26(12): 943-945.
21.	He LA, Wu LF, Su GD, et al. The efficacy of neoadjuvant chemotherapy in different histological types of cervical cancer. Gynecol Oncol, 2014, 134(2): 419-425.
22.	Mabuchi S, Okazawa M, Matsuo K, et al. Impact of histological subtype on survival of patients with surgically-treated stage ⅠA2-ⅡB cervical cancer: adenocarcinoma <italic>versus</italic> squamous cell carcinoma. Gynecol Oncol, 2012, 127(1): 114-120.
23.	Takekida S, Fujiwara K, Nagao S, et al. Phase Ⅱ study of combination chemotherapy with docetaxel and carboplatin for locally advanced or recurrent cervical cancer. Int J Gynecol Cancer, 2010, 20(9): 1563-1568.
24.	Moore DH. Neoadjuvant chemotherapy for cervical cancer. Expert Opin Pharmacother, 2003, 4(6): 859-867.
25.	Porzio G, Ficorella C, Toro G, et al. Short-term weekly neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer. Tumori, 2001, 87(1): 25-26.
26.	于月成, 汪海丹, 辛晓燕, 等. 术前介入化疗治疗巨块型宫颈癌 52 例疗效分析. 第四军医大学学报, 2004, 25(6): 557-559.
27.	Zanetta G, Lissoni A, Gabriele A, et al. Intense neoadjuvant chemotherapy with cisplatin and epirubicin for advanced or bulky cervical and vaginal adenocarcinoma. Gynecol Oncol, 1997, 64(3): 431-435.

1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2): 69-90.
2. Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin, 2005, 55(2): 74-108.
3. Zhou J, Li X, Huang K, et al. Young cervical cancer patients may be more responsive than older patients to neoadjuvant chemotherapy followed by radical surgery. PLoS One, 2016, 11(2): e0149534.
4. Tewari KS, Sill MW, Long IH, et al. Improved survival with bevacizumab in advanced cervical cancer. N Engl J Med, 2014, 370(8): 734-743.
5. Rein DT, Kurbacher CM, Breidenbach M, et al. Weekly carboplatin and docetaxel for locally advanced primary and recurrent cervical cancer: a phase Ⅰ study. Gynecol Oncol, 2002, 87(1): 98-103.
6. 何超蔓, 陈曼玲, 黎明鸾, 等. 宫颈癌新辅助化疗的临床初步观察. 海南医学院学报, 2009, 15(7): 764-766.
7. Micheletti E, La Face B, Bianchi E, et al. Continuous infusion of carboplatin during conventional radiotherapy treatment in advanced squamous carcinoma of the cervix uteri ⅡB-ⅢB (UICC). A phase Ⅰ/Ⅱ and pharmacokinetic study. Am J Clin Oncol, 1997, 20(6): 613-620.
8. 曹泽毅. 妇科常见肿瘤诊治指南. 3 版. 北京: 人民卫生出版社, 2012: 129-131.
9. Ferrandina G, Carbone A, Macchia G, et al. A complete pathological response to treatment in a young patient with locally advanced minimal deviation adenocarcinoma of the uterine cervix undergoing chemoradiation followed by radical surgery. Gynecol Obstet Invest, 2011, 72(2): 141-144.
10. 黄清华, 李力. 宫颈癌新辅助化疗临床研究现状. 国际妇产科学杂志, 2009, 36(5): 380-383.
11. Iwata T, Miyauchi A, Suga Y, et al. Neoadjuvant chemotherapy for locally advanced cervical cancer. Chin J Cancer Res, 2016, 28(2): 235-240.
12. De Azevedo CR, Thuler LC, De Mello MJ, et al. Neoadjuvant chemotherapy followed by chemoradiation in cervical carcinoma: a review. Int J Gynecol Cancer, 2016, 26(4): 729-736.
13. Lapresa M, Parma G, Portuesi R, et al. Neoadjuvant chemotherapy in cervical cancer: an update. Expert Rev Anticancer Ther, 2015, 15(10): 1171-1181.
14. Ye Q, Yuan HX, Chen HL. Responsiveness of neoadjuvant chemotherapy before surgery predicts favorable prognosis for cervical cancer patients: a meta-analysis. J Cancer Res Clin Oncol, 2013, 139(11): 1887-1898.
15. Yang L, Guo J, Shen Y, et al. Clinical efficacy and safety of paclitaxel plus caoplatin as neoadjuvant chemotherapy prior to radical hysterectomy and pelvic lymphadenectomy for Stage ⅠB2-ⅡB cervical cancer. Int J Clin Exp Med, 2015, 8(8): 13690-13698.
16. Kim HS, Sardi JE, Katsumata N, et al. Efficacy of neoadjuvant chemotherapy in patients with FIGO stage ⅠB1 to ⅡA cervical cancer: an international collaborative meta-analysis. Eur J Surg Oncol, 2013, 39(2): 115-124.
17. Basile S, Angioli R, Manci N, et al. Gynecological cancers in developing countries: the challenge of chemotherapy in low-resources setting. Int J Gynecol Cancer, 2006, 16(4): 1491-1497.
18. Rydzewska L, Tierney J, Vale CL, et al. Neoadjuvant chemotherapy plus surgery <italic>versus</italic> surgery for cervical cancer. Cochrane Database Syst Rev, 2010(1): CD007406.
19. 王毅军, 蒋本贵. 不同方法治疗 Ⅰb2-Ⅱa2 期巨块型宫颈癌的疗效观察. 武汉大学学报: 医学版, 2014, 35(4): 620-623.
20. 曲思娆, 武昕, 赵晶, 等. 单纯放疗、新辅助化疗及同步放化疗治疗宫颈癌临床近期疗效比较. 中国实用妇科与产科杂志, 2010, 26(12): 943-945.
21. He LA, Wu LF, Su GD, et al. The efficacy of neoadjuvant chemotherapy in different histological types of cervical cancer. Gynecol Oncol, 2014, 134(2): 419-425.
22. Mabuchi S, Okazawa M, Matsuo K, et al. Impact of histological subtype on survival of patients with surgically-treated stage ⅠA2-ⅡB cervical cancer: adenocarcinoma <italic>versus</italic> squamous cell carcinoma. Gynecol Oncol, 2012, 127(1): 114-120.
23. Takekida S, Fujiwara K, Nagao S, et al. Phase Ⅱ study of combination chemotherapy with docetaxel and carboplatin for locally advanced or recurrent cervical cancer. Int J Gynecol Cancer, 2010, 20(9): 1563-1568.
24. Moore DH. Neoadjuvant chemotherapy for cervical cancer. Expert Opin Pharmacother, 2003, 4(6): 859-867.
25. Porzio G, Ficorella C, Toro G, et al. Short-term weekly neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer. Tumori, 2001, 87(1): 25-26.
26. 于月成, 汪海丹, 辛晓燕, 等. 术前介入化疗治疗巨块型宫颈癌 52 例疗效分析. 第四军医大学学报, 2004, 25(6): 557-559.
27. Zanetta G, Lissoni A, Gabriele A, et al. Intense neoadjuvant chemotherapy with cisplatin and epirubicin for advanced or bulky cervical and vaginal adenocarcinoma. Gynecol Oncol, 1997, 64(3): 431-435.

West China Medical Journal

Clinical efficacy and safety of neo-adjuvant chemotherapy for stageⅠ_B2-Ⅱ_B cervical cancer

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