Neoadjuvant chemotherapy using platinum- and taxane-based regimens for bulky stage Ib2 to IIb non-squamous cell carcinoma of the uterine cervix

Cancer Chemother Pharmacol. 2013 Mar;71(3):657-62. doi: 10.1007/s00280-012-2052-2. Epub 2012 Dec 23.

Abstract

Purpose: There are no reports on the use of neoadjuvant chemotherapy (NAC) in non-squamous cell cervical carcinoma. We examined the effectiveness and safety of paclitaxel/carboplatin (TC) and docetaxel/carboplatin (DC).

Methods: Stage Ib2 to IIb disease was present in 23 patients scheduled for radical hysterectomy. We administered 1-3 courses of either the TC or the DC regimen. Anti-tumor effects were found superior by Response Evaluation Criteria in Solid Tumors. Safety was assessed with National Cancer Institute Common Terminology Criteria for Adverse Events.

Results: Median age was 50 years (range 32-63 years), with stage Ib2 in 6 cases (26.1%) and IIb in 17 cases (73.9%). Complete response was achieved in 5 cases (21.7%), partial response in 13 (56.5%), stable disease in 5 (21.7%); the response rate was 78.3%, and surgery completion rate was 78.3%. Leukopenia or neutropenia ≥grade 3 was seen in 12 (52.2%) and 21 (91.3%) cases, respectively, with grade 3 febrile neutropenia in 2 cases (8.7%) and no anemia or thrombocytopenia ≥grade 3. Median progression-free survival was 26 months (95% Cl, 13.5-38.5 months); median overall survival was 35 months (95% Cl, 20.9-49.1 months).

Conclusion: NAC for non-squamous cell cervical carcinoma showed potent anti-tumor effects and manageable adverse events.

MeSH terms

  • Adult
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Female
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Neoplasm Staging
  • Neutropenia / chemically induced
  • Neutropenia / drug therapy
  • Organoplatinum Compounds / administration & dosage
  • Pilot Projects
  • Postoperative Care
  • Survival Analysis
  • Taxoids / administration & dosage
  • Treatment Outcome
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / surgery
  • Uterine Cervical Neoplasms / therapy*

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Phytogenic
  • Organoplatinum Compounds
  • Taxoids
  • Granulocyte Colony-Stimulating Factor