RESUMO
We examined the efficacy and safety of neoadjuvant intra-arterial chemotherapy (NAC) followed by radical hysterectomy and/or radiotherapy in patients with stage IIIb cervical cancer. Treatment consisted of bilateral internal iliac artery infusion of cisplatin or carboplatin and peplomycin every 21 days for two courses. Patients who responded to NAC underwent radical surgery. Patients who did not respond to NAC were treated with pelvic radiotherapy. Complete response was achieved in 2 (7.1%) of 28 patients, while a partial response was observed in 17 (60.7%) and stable disease in 9 (32.1%) patients. Sixteen patients (57.2%) were able to undergo surgery. The median blood loss (674 ml) and operating time (232 min) for radical surgery in patients with stage IIIb disease was similar to that in patients with stages Ib to IIb disease. No intra-operative or immediate postoperative complications were observed. The 5-year disease-free survival (DFS) for patients who underwent surgery (81.3%) was higher than for patients who underwent radiotherapy after NAC (31.3%). Radical surgery after NAC for stage IIIb disease was safe, and a survival benefit followed by surgery with or without radiotherapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/cirurgia , Terapia Neoadjuvante , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias do Colo do Útero/cirurgia , Adulto , Idoso , Carboplatina/administração & dosagem , Carcinoma de Células Escamosas/patologia , Quimioterapia Adjuvante , Cisplatino/administração & dosagem , Feminino , Humanos , Histerectomia , Excisão de Linfonodo , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Peplomicina/administração & dosagem , Análise de Sobrevida , Neoplasias do Colo do Útero/patologiaRESUMO
Between April 1989 and December 1992, 38 patients with endometrial cancer who were at high risk for recurrence entered a prospective study designed to evaluate the efficacy of adjuvant platinum (cisplatin), adriamycin (doxorubicin), and cytoxan (cyclophosphamide) (PAC) chemotherapy. Patients received cisplatin (50 mg/m(2)) doxorubicin (30 mg/m(2)) and cyclophosphamide (500 mg/m(2)) at 3-week intervals for 2-3 cycles. All patients completed the treatment, there were no life-threatening adverse events. The median duration of follow-up was 52.9+/-16.9 months. Six patients developed a recurrence, and 4 of them died after a median interval of 45.5 months. Five of the six patients with recurrence had stage IIIc disease. The 3-year progression-free survival was 83.3%, the overall survival rate was 89.2%. Results suggest that adjuvant chemotherapy with PAC may reduce the incidence of recurrence and improve the survival rate of patients with endometrial cancer.