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.

Expression of Ras Oncogene in the Intracpithelial Neoplasia and Carcinoma of the Uterine Cervix / 대한부인종양콜포스코피학회잡지

Cellular oncogenes are expressed as an intrinsic part of the transformed or neoplastic phenotype. More than 60 of the known cellular oncogenes play a specific role in normal cellular development and differentiation. To examine the correlation between ras oncogene expression and the development of cervical cancer, this study investigated the reactivity of cervical intraepithelial neoplasia(CIN) and carcinoma of the uterine cervix by using anti-ras P21 mouse monoclonal antibody. The expression of ras oncogene significantly increased with the grade of malignancy from 11% in severe dysplasia, 30% in carcinoma in situ, 43% in microinvasive carcinoma, to 53% in invasive cancer. The expression of ras oncogene was not correlated with histologic type, tumor size, and nodal status of cervical cancer. It was concluded that expression of ras oncogene is related to early phase of carcinogenesis and tumor invasion of carcinoma of the uterine cervix.