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Abou-Taleb HA, Koshiyama M, Matsumura N, Baba T, Yamaguchi K, Hamanishi J, Abiko K, Yamanoi K, Murakami R, Horikawa N, Taha AA, Kitamura S, Konishi I. Clinical efficacy of neoadjuvant chemotherapy with irinotecan (CPT-11) and nedaplatin followed by radical hysterectomy for locally advanced cervical cancer. J Int Med Res 2016; 44:346-56. [PMID: 26831404 PMCID: PMC5580053 DOI: 10.1177/0300060515591858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 05/27/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the clinical efficacy of neoadjuvant chemotherapy (NAC) with irinotecan (CPT-11) and nedaplatin (NED) followed by radical hysterectomy. METHODS Patients with locally advanced cervical cancer (stage Ib2-IIb) were treated with NAC followed by surgery, primary surgery or primary radiotherapy. NAC was usually performed using transuterine arterial chemotherapy (TUAC) or intravenous CPT-11/NED. Survival rates were analysed in the three treatment groups; response rates and adverse events associated with NAC, TUAC and CPT-11/NED were compared, along with previously reported adverse events of chemoradiotherapy. RESULTS A total of 165 patients with cervical cancer were recruited. Of these, 70 were treated with NAC followed by surgery (48 with CPT-11/NED, 18 with TUAC and four with other types of chemotherapy), 73 were treated with primary surgery and 22 with primary radiotherapy (including chemoradiotherapy). There were no significant differences in progression-free survival or overall survival rates between the three treatment groups. The response rates for the NAC regimen of CPT-11/NED and TUAC were high (75% and 78%, respectively). The frequency of severe thrombocytopenia was lower in patients receiving CPT-11/NED compared with TUAC, and the incidence of severe anaemia, vomiting and cystitis was lower in patients receiving CPT-11/NED compared with chemoradiotherapy. CONCLUSIONS The use of CPT-11/NED as a NAC regimen shows favourable activity, with lower toxicity compared with NAC using TUAC or chemoradiotherapy, for the treatment of locally advanced cervical cancer.
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Affiliation(s)
- Hisham A Abou-Taleb
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan Department of Obstetrics and Gynaecology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Masafumi Koshiyama
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriomi Matsumura
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsukasa Baba
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ken Yamaguchi
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junzo Hamanishi
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kaoru Abiko
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Yamanoi
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryusuke Murakami
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoki Horikawa
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ahmed Aa Taha
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan Department of Obstetrics and Gynaecology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Sachiko Kitamura
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ikuo Konishi
- Department of Gynaecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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