ABSTRACT
Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stageâIB2-IIB with an estimated 5-year overall survival of 60%. During the last decades, the initial treatment for these women has been debated and largely varies through different countries. Thus, radical concurrent chemoradiation is the standard of care in United Sated and Canada, and neoadjuvant chemotherapy followed by radical surgery is the first line of treatment in some institutions of Europe, Asia and Latin America. Until today, there is no evidence of which strategy is better over the other. This article describe the evidence as well as the advantages and disadvantages of the main strategies of treatment for women affected by uterine cervical cancer stageâIB2-IIB.
ABSTRACT
PURPOSE: Assess the surgical complications of primary tumor resection in stage IV colon cancer patients previously treated with neoadjuvant chemotherapy. METHODS: Between July 2001 and September 2010, 67 consecutive patients received preoperative chemotherapy. Clinical and surgical complications were obtained from the medical records. This study was retrospective in design. RESULTS: All patients were affected with liver metastasis, and 29.8% had metastasis in additional organs. Three different schemes of preoperative chemotherapy were employed, based on FOLFIRI, XELOXIRI or XELOX plus cetuximab. Eighteen patients (26.8%) reported some side effects to the chemotherapy, without contraindicating any intervention. All patients underwent colon surgery and within those, eight patients (11.9%), underwent liver surgery simultaneously. Median hospital admission was 8 [3-29] days. The perioperative complication rate was 16.2%, when the estimated physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) was 58.3%. There was not perioperative mortality, despite the mortality prediction for Portsmouth-POSSUM (P-POSSUM) being 5.07%. No differences were observed between the chemotherapy regimen (P=0.72) or the kind of the surgery-simple or combined (P=0.58). CONCLUSIONS: Neoadjuvant chemotherapy as a systemic treatment for stage IV colon cancer does not indicate surgery contraindication nor increases postoperative morbimortality by a significant amount.
ABSTRACT
Objective To evaluate the influence and significance of Pingyangmycin chemotherapy on the c-myc and Ras-P21 protein expression in penile cancer .Methods A total of 100 penile squamous cell carci-noma cases was retrospectively studied and divided into two groups .Data were obtained from 1995 to 2005 .In the chemotherapy group ,50 cases of patients were selected to perform preoperative chemotherapy before surgery .The patients were treated by Pingyangmycin .After 7 times of medication ,partial excision of penis plus improved ingui-nal lymph node dissection was performed .In the control group ,50 cases of patients were selected for partial exci-sion of penis plus improved inguinal lymph node dissection directly without any pre -operative chemotherapy .All pathology specimens were detected of c -myc and Ras-P21 protein expression by immunohistochemical staining assay.Theχ2 test was used for the statistical analysis .Results In chemotherapy group,the positive expression rates of c-myc and Ras-P21 were 30%,27%,respectively.However,in control group,the positive expression rate of c-myc,Ras-P21 were 52%,48%,respectively.By theχ2 test,the expressive differences of c -myc,Ras-P21 positive expression rate between chemotherapy group and control group were all significant (P<0.05). Conclusion The protein expressions of c -myc and Ras-P21 is significantly decreased in the tissue of Pingy-angmycin chemotherapy of penile cancer .
ABSTRACT
Purpose: To study the short-term efficacy and toxicity of the neoajuvant chemotherapy with epirubicin (EPI) plus paclitaxel( TAX) in treatment of patients with breast cancer. Methods: 20 patients with stage Ⅱ,Ⅲ breast cancer were treated with paclitaxel plus epirubicin (TE) for 2 - 4 cycles every 3 weeks, their clinical response and the toxicity were assessed after 2-4 cycles of neoajuvant chemotherapy, and they are compared with those of the patients treated with vinorelbine plus epirubicin( VE) as neoadjuvant chemotherapy. Patients in TE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, paclitaxel 150 mg/m2 by 3-hour continuous infusion on d 2, 3 weeks was 1 cycle. Patients assigned to the VE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, vinorelbine 30 mg/m by intravenous injection on d 1 and d 8, 4 weeks was 1 cycle. All patients were treated by modified radical operation after neoajuvant chemotherapy. Results: The overall response rate( RR) was 80% (16/20) both in TE arm and VE arm. There were 3(15%) clinical complete response( cCR) and 2(10%) pathologic complete response ( pCR) in every arm. No patient showed progressive disease. A higher proportion of RR and pCR was observed in patients with 4 cycles of neoajuvant chemotherapy than those with 2 cycles in the two groups. The major toxicity, including leukopenia, gastroenteric reaction, flushing of face and phlebitis, were similar in both groups, but fatigue, alopecia and neurotoxicity were more severe in VE arm than in TE arm(P
ABSTRACT
Background and purpose:It is difficult to diagnose gastric cancer at an early stage,thus the resectable probability of gastric cancer is low.This study was to explore the efficacy of neoajuvant chemotherapy in terms of resectablity for the patients with advanced gastric cancer.Methods:Eighty-six patients with advanced gastric cancer were randomly divided into routine surgical operation group and neoajuvant chemotherapy+surgical operation group.The patients were examined by CT before surgery.The patients in neoajuvant chemotherapy+surgical operation group received two cycles of neoajuvant chemotherapy,and then were evaluated by CT.Results:In routine surgical operation group,the overall resectability rate was 83.7%(36/43),and the curative resection rate was 46.5%(20/43), 16.3%(7/43)was done by exp.lap.In neoajuvant chemotherapy+surgical operation group,the overall resectability rate was 93.0%(40/43),and the curative resection rate was 69.8%(30/43),only 7.0%(3/43)was exp.lap.No mortality was observed.There were no significant difference between both groups in terms of toxicities.Conclusions:The overall resectability rate and the curative resection rate are increased in patients with advanced gastric cancer aider neoajuvant chemotherapy.
