Phase II Study of CP (Cisplatin/Paclitaxel) as Neoadjuvant Chemotherapy in Patients with Locally Advanced Cervical Carcinoma / 대한산부인과학회지

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.

A Case Report of Sclerosing Stromal Tumor of the Ovary / 대한산부인과학회잡지

Sclerosing stromal tumor is a rare benign neoplasm of ovarian stromal origin, distinct from the thecoma-fibroma group and steroid (lipid) cell tumors clinically, pathologically, and radiographically. Unlike the thecoma-fibroma group of ovarian stromal tumors, which tend to occur in the fifth and sixth decades, the sclerosing stromal tumor predominantly affects young women with a mean age of 28 years. Microscopic examination reveals a heterogenous picture that is characterized by sclerosis, prominant vascularity and a disorganized admixture of fibroblasts and vacuolated cells. We could not demonstrate unequivocal hormonal activity in this case, although suggestive evidence for it has been reported in the literature in the form of clinical, histologic, electron microscopic and immunohistochemical findings. We recently experienced a case of sclerosing stromal tumor of the ovary in 20 year-old virgin woman. We report a case here with a brief review of the literature.