국소적으로 진행된 자궁경부암환자에서 선행 보조항암요법으로 시행된 Paclitaxel과 Cisplatin의 Phase Ⅱ 연구

Abstract

OBJECTIVE: The goal of this study was to identify the toxicity and effectivity of paclitaxel and cisplatin as neoadjuvant chemotherapy in cervical cancer. METHODS: Between January 2000 and December 2003, 53 patients with bulky or locally advanced cervical cancer (FIGO stage Ib, IIa, IIb, IV) which confirmed by pathologist. Stage Ib was restricted to bulky or locally advanced cervical cancer which lesions larger than 4 cm. The toxicity of the regimen in each cycle was determined according to the WHO toxicity criteria. Before the neoadjuvant chemotherapy, the lesion was pathologically confirmed by punch biopsy or cone biopsy and the size of tumor mass and metastasis were measured by pelvic examnination and pelvic magnetic resonance imaging (MRI). The response of the treatment was determined by pelvic examnination and pelvic magnetic resonance imaging (MRI) after three cycles of chemotherapy. RESULTS: A total of 53 patients were enrolled in this study and 38 patients (61%) were given an operation. Clinical responses occured in 89% (34/53) of patients, including 42% (16/38) with a pathologically determined complete response (CR), 21% (11/53) with a partial response (PR), 11% (6/53) showed stable disease (ST) A down-staging response was seen in 74% (39/53) of patients. Hepatotoxicity was seen in 12 patients, but Anorexia, Nausea and Vomitting was 34, 49 patients respectively. But most toxicity were grade 1, 2 except granulocytopenia. CONCLUSION: Neoadjuvant chemotherapy with paclitaxel and cisplatin on locally advanced cervical cancer yielded a 68% complete response (CR) and 21% partial response (PR) with tolerable toxicity. This results imply that neoadjuvant chemotherapy might be accepted as a tool in treating locally advanced cervical cancer in order to improve the likelihood of favorable outcomes. But large number of cases and following up of survival rate need to be studied to confirm he efficacy of the treatment.