ABSTRACT
Four cases of clinical Stage I endometrial carcinoma initially treated with hormonal therapy are included in this study. Three of them resulted in tumor regression and two of them permitted a subsequent three pregnancies. All patients are alive and without evidence of disease with a median follow-up of 35.7 months (range 17 to 72 months). We believe this is a promising approach through which we may be able to offer a conservative treatment maintaining high survival rates and preserving childbearing potential. Diagnostic and therapeutic data for fertility-desiring patients with endometrial carcinoma are analyzed in this study.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents, Hormonal/therapeutic use , Endometrial Neoplasms/drug therapy , Medroxyprogesterone Acetate/therapeutic use , Adenocarcinoma/pathology , Adult , Biopsy, Needle , Endometrial Neoplasms/pathology , Female , Follow-Up Studies , Humans , Neoplasm Staging , Treatment OutcomeABSTRACT
Determinar la factibilidad y el rol de la quimioterapia neoadyuvante(PQT) utilizada previamente a la operación de Werttheim Meigs (Cx) o al tratamiento radiante convencional (RT)
Subject(s)
Humans , Female , Adult , Middle Aged , Uterine Cervical Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Retrospective StudiesABSTRACT
Determinar la factibilidad y el rol de la quimioterapia neoadyuvante(PQT) utilizada previamente a la operación de Werttheim Meigs (Cx) o al tratamiento radiante convencional (RT)
Subject(s)
Humans , Female , Adult , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Retrospective Studies , Uterine Cervical Neoplasms/drug therapyABSTRACT
A prospective randomized trial was carried out in patients with squamous carcinoma of the cervix uteri, stage Ib bulky. The protocol considers two arms: the control group (75 patients) and the neoadjuvant one (76 patients). All the patients were classified according to the FIGO staging system and in order to determine the tumor size objectively, an ultrasound scanning was done. After this a Wertheim-Meigs operation followed by adjuvant whole-pelvis irradiation was performed. In the neoadjuvant group the same procedures were carried out but three courses of chemotherapy with the "quick" VBP scheme were given before the treatment. The new therapeutic strategy proved to be very useful in bulky tumors in which the clinical examination showed a cervix increased in size and the ultrasound scanning a volume larger than 60 c.c. (> 4 x 4 x 4 cm). In those cases statistically significant differences were found between both groups when free disease interval and survival were considered. These were due to the fact that operability has been improved and the parametrial extension has been decreased as well as other risk factors such as vascular embolism, lymph node involvement, tumor-cervix quotient, and tumor volume. The use of this new strategy is not justified in small tumors (< 3-4 cm in diameter) because in those cases, survival is not improved with neoadjuvant therapy.
