Phase II study of neoadjuvant chemotherapy with irinotecan hydrochloride and nedaplatin followed by radical hysterectomy for bulky stage Ib2 to IIb, cervical squamous cell carcinoma: Japanese Gynecologic Oncology Group study (JGOG 1065)

Yamaguchi,Satoshi; Nishimura,Ryuichiro; Yaegashi,Nobuo; Kiguchi,Kazushige; Sugiyama,Toru; Kita,Tsunekazu; Kubushiro,Kaneyuki; Kokawa,Katsuji; Hiura,Masamichi; Mizutani,Katsumi; Yamamoto,Kaichiro; Takizawa,Ken

doi:10.3892/or.2012.1814

Phase II study of neoadjuvant chemotherapy with irinotecan hydrochloride and nedaplatin followed by radical hysterectomy for bulky stage Ib2 to IIb, cervical squamous cell carcinoma: Japanese Gynecologic Oncology Group study (JGOG 1065)

Authors:
- Satoshi Yamaguchi
- Ryuichiro Nishimura
- Nobuo Yaegashi
- Kazushige Kiguchi
- Toru Sugiyama
- Tsunekazu Kita
- Kaneyuki Kubushiro
- Katsuji Kokawa
- Masamichi Hiura
- Katsumi Mizutani
- Kaichiro Yamamoto
- Ken Takizawa
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Affiliations: Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan, Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan, Department of Obstetrics and Gynecology, Tohoku University School of Medicine Hospital, Sendai, Miyagi 980-8574, Japan, Department of Obstetrics and Gynecology, St. Marianna University School of Medicine Hospital, Kawasaki, Kanagawa 216-8511, Japan, Department of Obstetrics and Gynecology, Iwate Medical University Hospital, Morioka, Iwate 020-8505, Japan, Department of Obstetrics and Gynecology, Nara Hospital, Nara 631-0846, Japan, Department of Obstetrics and Gynecology, Toho University Ohashi Hospital, Tokyo 153-8515, Japan, Kokawa Clinic, Wakayama 640-8482, Japan, Department of Gynecology, Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan, Department of Obstetrics and Gynecology, Sakai Hospital Kinki University School of Medicine, Sakai, Osaka 590-0132, Japan, Department of Gynecology, Cancer Institute Hospital, Ariake, Tokyo 135-8550, Japan
Published online on: May 14, 2012 https://doi.org/10.3892/or.2012.1814
Pages: 487-493

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Abstract

The efficacy and adverse events of neoadjuvant chemotherapy with irinotecan hydrochloride and nedaplatin were evaluated in patients with bulky stage Ib2 to IIb cervical squamous cell carcinoma. Eligibility included patients who received irinotecan (60 mg/m2) on days 1 and 8 and nedaplatin (80 mg/m2) on day 1 of a 21-day cycle. After 1-3 courses of chemotherapy, radical hysterectomy was performed. Sixty-eight patients were enrolled. Sixty-six were included in the full analysis set. Their median age was 47 years (range 22-71), the FIGO stage was Ib2 in 18 patients, IIa in 10, and IIb in 38. Radical hysterectomy was performed after NAC in 63 patients (95.5%). The number of administered courses of NAC was 1 in 13 patients, 2 in 43, and 3 in 10. The response rate, the primary endpoint of this study, was 75.8% (CR in 2 patients, PR in 48, SD in 12, PD in 0, and NE in 4). The mean number of treatment courses required for a response was 1.42 (1 course in 30 patients, 2 courses in 19, and 3 courses in 1). The incidences of grade 3 or 4 hematological toxicities were: neutropenia 72.2%, leukopenia 16.7%, anemia 13.6%, thrombocytopenia 7.6%, febrile neutropenia 1.5%, and elevations of alanine aminotransferase and aspartate aminotransferase 1.5%. Grade 3 or 4 non-hematologic toxicities were as follows: diarrhea 6.1%, nausea 3%, anorexia 1.5%, vomiting 1.5%, fever 1.5%, allergic reactions 1.5%, ileus 1.5% and vesicovaginal fistula 1.5%. Neoadjuvant chemotherapy with irinotecan and nedaplatin was an effective and well-tolerated treatment for patients with bulky stage Ib2 to IIb squamous cell carcinoma of the uterine cervix.

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