The Effects of FAC neoadjuvant Chemotherapy in Locally Advanced and Bulky Cervical Cancer / 대한부인종양콜포스코피학회잡지

The goals of any new cervical cancer chemotherapy should include; a decrease in toxicity, better distant and local control of the disease, prolongation of survival, improvement in the quality of life and palliation of symptoms. The goal of FAC (5-Fluorouracil, Interferon alpha-2a, Carboplatin) neoadjuvant chemothe-raphy is for better surgical therapeutic results in locally advanced and bulky lesions with preo-perative chemotheraphy. This new trend in management of cervical cancer may provide the benefits as follows; reduction of the tumor size, a decrease in numbers of involved lymph nodes, control of microscopically metastatic lesions, improvement of the effects of radiation therapy and providing the chance of operability by lowering the clinical stage than initial prechemotherapy stage. The purpose of this study is to evaluate the effect of FAC neoadjuvant chemotherapy on reducing the size of tumors in cervical cancer. 17 patients in stage I b2, IIa, IIb carcinoma of cervix were treated with FAC regimen; Interferon alpha-2a 6 MIU given subcutaneously on day 1~6, 5-Fluorouracil 750 mg/m(2) given intravenously on day 2~6 and Carboplatin 350 mg/m2 given intravenously on 2nd day. The overall response rate was 58.5%, including 2 complete responses(11.7%) and 8 partial responses(47.1%). Neoadjuvant chemotherapy reduced the mean cervical lesion area from 23.1+9.97 cm(2) to 8.65+5.95 cm(2) in response group. The toxicity was acceptable in this group and the frequent toxicity was myelosuppression. Although limitation of this study are the lack of randomization and the small sample size, FAC neoadjuvant chemotheraphy is a potentially useful modality in the management of patients with locally advanced bulky cervical cancer.

A Clinical Study of Ifosfamide/Mesna and Cisplatin in Recurrent Epithelial Ovarian Cancer / 대한산부인과학회잡지

This study was planned to evaluate the efficacy and toxicity of fosfamide/mesna plus cisplatin combined regimen in patients with recurrent and initial therapy-resistant epithelial ovarian cancer. Controversy still remains over the efficacy of cisplatin containing combined chemotherapy as the treatment of recurrent ovarian cancer and refractory to first line chemotherapy. Ifosfamide(isophosphamide) is an analog of cyclophosphamide. It has shown evidences of activity in ovarian cancer and lack of cross-resistance with cyclophosphamide. This study was undertaken for the clinical analysis and evaluation on 16 patients, who were admitted and treated with advanced or recurrent ovarian cancer at the Sooncheunhyang University Chunan Hospital from January 1994 to July 1996. The results were as follows: 1. The mean age of patients was 62 year old with range from 44 to 72. 2. The most frequent side effect was nausea and vomiting(75%), followed by leukocytopenia(68%), alopecia(44%), nephrotoxicity(37%), neurotoxicity(25%), and hepatotoxicity(12%). 3. The mean survival period was 24 months in clinical response cases ranged from 11 months to 36 months, 5 months in progressive cases ranged from 1 month to 14 months. 4. In clinical stages, stage II was 6 cases(37.5%), III was 6 cases(37.5%) and IV was 4 cases(25%). 5. Previously all patients were received debulking surgery and PAC hemotherapy. 6. Overall respons rate was 44%(7/16).