Neoadjuvant intraarterial chemotherapy for stage IIB-IIIB cervical cancer in Japanese women

Kaku,Shoji; Takahashi,Kentaro; Murakami,Yoshitaka; Wakinoue,Shirou; Nakagawa,Tetsuya; Shimizu,Yoshihiko; Kita,Nobuyuki; Noda,Yoichi; Murakami,Takashi

doi:10.3892/etm_00000102

Neoadjuvant intraarterial chemotherapy for stage IIB-IIIB cervical cancer in Japanese women

Authors:
- Shoji Kaku
- Kentaro Takahashi
- Yoshitaka Murakami
- Shirou Wakinoue
- Tetsuya Nakagawa
- Yoshihiko Shimizu
- Nobuyuki Kita
- Yoichi Noda
- Takashi Murakami
View Affiliations

Affiliations: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan. kaku@med.kawasaki-m.ac.jp
Published online on: July 1, 2010 https://doi.org/10.3892/etm_00000102
Pages: 651-655

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Chemoradiotherapy is currently the main treatment for locally advanced cervical cancer, but neoadjuvant intraarterial chemotherapy (IA-NAC) has been reported to achieve favorable results. This study investigated the efficacy of several different IA-NAC regimens. The subjects were 55 patients with stage IIB-IIIB cervical cancer who received IA-NAC between January 1991 and April 2006. IA-NAC was administered for a total of 1-3 courses at 3-week intervals, with three different regimens being employed in chronological order. The response rate achieved with IA-NAC was 90.2% for squamous cell carcinoma, 60% for adenosquamous carcinoma and 42.9% for adenocarcinoma. Surgery was performed after IA-NAC in 36 patients, and radiotherapy alone was performed in 19 patients. The 5-year survival rate was 72.9% for patients with squamous cell carcinoma and 50% for those with adenocarcinoma or adenosquamous carcinoma. PAMF therapy (cisplatin, epirubicin, mitomycin-C and 5-fluorouracil) achieved a response rate of ≥90% for squamous cell carcinoma, as did CDDP + THP therapy (cisplatin plus pirarubicin), while PACF therapy (cisplatin, epirubicin, cyclophosphamide and 5-flurouracil) achieved a better response rate for adenosquamous carcinoma and adenocarcinoma. Grade 3 or 4 hematological toxicity was significantly more common with PAMF therapy. In conclusion, IA-NAC improved the survival of patients with squamous cell carcinoma. CDDP + THP therapy achieved a high response rate with little hematologic toxicity. PACF therapy achieved a significantly higher response rate in patients with adenosquamous carcinoma or adenocarcinoma. Therefore, IA-NAC may be a therapeutic option for locally advanced cervical cancer, particularly using the above-mentioned regimens.

View Figures

View References

1.	Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, Clarke-Pearson DL and Insalaco S: Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 340:1144–1153. 1999. View Article : Google Scholar : PubMed/NCBI
2.	Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE, Rotman M, Gershenson DM and Mutch DG: Pelvic radiation with concurrent chemotherapy compared with pelvic and paraaortic radiation for high-risk cervical cancer. N Engl J Med. 340:1137–1143. 1999. View Article : Google Scholar : PubMed/NCBI
3.	Whitney CW, Sause W, Bundy BN, Malfetano JH, Hannigan EV, Fowler WC Jr, Clarke-Pearson DL and Liao SY: Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB–IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol. 17:1339–1348. 1999.PubMed/NCBI
4.	Sardi JE, Giaroli A, Sananes C, Ferreira M, Soderini A, Bermudez A, Snaidas L, Vighi S, Gomez Rueda N and di Paola G: Long-term follow-up of the first randomized trial using neoadjuvant chemotherapy in stage Ib squamous carcinoma of the cervix: the final results. Gynecol Oncol. 67:61–69. 1997. View Article : Google Scholar : PubMed/NCBI
5.	Benedetti-Panici P, Greggi S, Colombo A, Amoroso M, Smaniotto D, Giannarelli D, Amunni G, Raspagliesi F, Zola P, Mangioni C and Landoni F: Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer: results from the Italian multi-center randomized study. J Clin Oncol. 20:179–188. 2002. View Article : Google Scholar
6.	Neoadjuvant Chemotherapy for Locally Advanced Cervical Cancer Meta-analysis Collaboration: Neoadjuvant chemotherapy for locally advanced cervical cancer: a systematic review and meta-analysis of individual patient data from 21 randomised trials. Eur J Cancer. 39:2470–2486. 2003. View Article : Google Scholar : PubMed/NCBI
7.	Chang TC, Lai CH, Hong JH, Hsueh S, Huang KG, Chou HH, Tseng CJ, Tsai CS, Chang JT, Lin CT, Chang HH, Chao PJ, Ng KK, Tang SG and Soong YK: Randomized trial of neoadjuvant cisplatin, vincristine, bleomycin, and radical hysterectomy versus radiation therapy for bulky stage IB and IIA cervical cancer. J Clin Oncol. 18:1740–1747. 2000.
8.	Kumar L, Kaushal R, Nandy M, Biswal BM, Kumar S, Kriplani A, Singh R, Rath GK and Kochupillai V: Chemotherapy followed by radiotherapy versus radiotherapy alone in locally advanced cervical cancer: a randomized study. Gynecol Oncol. 54:307–315. 1994. View Article : Google Scholar : PubMed/NCBI
9.	Sundfor K, Trope CG, Hogberg T, Onsrud M, Koern J, Simonsen E, Bertelsen K and Westberg R: Radiotherapy and neoadjuvant chemotherapy for cervical carcinoma. A randomized multicenter study of sequential cisplatin and 5-fluorouracil and radiotherapy in advanced cervical carcinoma stage 3B and 4A. Cancer. 77:2371–2378. 1996. View Article : Google Scholar
10.	Souhami L, Gil RA, Allan SE, Canary PC, Araujo CM, Pinto LH and Silveira TR: A randomized trial of chemotherapy followed by pelvic radiation therapy in stage IIIB carcinoma of the cervix. J Clin Oncol. 9:970–977. 1991.PubMed/NCBI
11.	Tattersall MH, Lorvidhaya V, Vootiprux V, et al: Randomized trial of epirubicin and cisplatin chemotherapy followed by pelvic radiation in locally advanced cervical cancer. Cervical Cancer Study Group of the Asian Oceanian Clinical Oncology Association. J Clin Oncol. 13:444–451. 1995.
12.	Park SY, Kim BG, Kim JH, Lee JH, Lee ED, Lee KH, Park KB, Lee BH and Kim KH: Phase I/II study of neoadjuvant intraarterial chemotherapy with mitomycin-C, vincristine, and cisplatin in patients with stage IIb bulky cervical carcinoma. Cancer. 76:814–823. 1995. View Article : Google Scholar : PubMed/NCBI
13.	Scarabelli C, Zarrelli A, Gallo A and Visentin MC: Multimodal treatment with neoadjuvant intraarterial chemotherapy and radical surgery in patients with stage IIIB–IVA cervical cancer. A preliminary study. Cancer. 76:1019–1026. 1995.
14.	Sugiyama T, Nishida T, Hasuo Y, Fujiyoshi K and Yakushiji M: Neoadjuvant intraarterial chemotherapy followed by radical hysterectomy and/or radiotherapy for locally advanced cervical cancer. Gynecol Oncol. 69:130–136. 1998. View Article : Google Scholar
15.	Yamakawa Y, Fujimura M, Hidaka T, Hori S and Saito S: Neoadjuvant intraarterial infusion chemotherapy in patients with stage IB2–IIIB cervical cancer. Gynecol Oncol. 77:264–270. 2000.
16.	Piver MS, Rutledge F and Smith JP: Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol. 44:265–272. 1974.PubMed/NCBI
17.	Bierman HR, Byron RL Jr, Miller ER and Shimkin MB: Effects of intra-arterial administration of nitrogen mustard. Am J Med. 8:5351950. View Article : Google Scholar : PubMed/NCBI
18.	Cromer JK, Bateman JC, Berry GN, Kennelly JM, Klopp CT and Platt LI: Use of intra-arterial nitrogen mustard therapy in the treatment of cervical and vaginal cancer. Am J Obstet Gynecol. 63:538–548. 1952.PubMed/NCBI
19.	Toita T, Moromizato H, Ogawa K, Kakinohana Y, Maehama T, Kanazawa K and Murayama S: Concurrent chemoradiotherapy using high-dose-rate intracavitary brachytherapy for uterine cervical cancer. Gynecol Oncol. 96:665–670. 2005. View Article : Google Scholar : PubMed/NCBI
20.	Umesaki N, Fujii T, Nishimura R, Tanaka T, Nishida M, Fushiki H, Takizawa K, Yamamoto K, Hasegawa K and Izumi R: Phase II study of irinotecan combined with mitomycin-C for advanced or recurrent squamous cell carcinoma of the uterine cervix: the JGOG study. Gynecol Oncol. 95:127–132. 2004. View Article : Google Scholar : PubMed/NCBI
21.	Dimopoulos MA, Papadimitriou CA, Sarris K, Aravantinos G, Kalofonos C, Gika D, Gourgoulis GM, Efstathiou E, Skarlos D and Bafaloukos D: Combination of ifosfamide, paclitaxel, and cisplatin for the treatment of metastatic and recurrent carcinoma of the uterine cervix: a phase II study of the Hellenic Cooperative Oncology Group. Gynecol Oncol. 85:476–482. 2002. View Article : Google Scholar : PubMed/NCBI
22.	Papadimitriou CA, Sarris K, Moulopoulos LA, Fountzilas G, Anagnostopoulos A, Voulgaris Z, Gika D, Giannakoulis N, Diakomanolis E and Dimopoulos MA: Phase II trial of paclitaxel and cisplatin in metastatic and recurrent carcinoma of the uterine cervix. J Clin Oncol. 17:761–766. 1999.PubMed/NCBI
23.	Iwasaka T, Fukuda K, Hara K, Yokoyama M, Nakao Y, Uchiyama M and Sugimori H: Neoadjuvant chemotherapy with mitomycin C, etoposide, and cisplatin for adenocarcinoma of the cervix. Gynecol Oncol. 70:236–240. 1998. View Article : Google Scholar : PubMed/NCBI
24.	Lissoni A, Gabriele A, Gorga G, Tumolo S, Landoni F, Mangioni C and Sessa C: Cisplatin-, epirubicin- and paclitaxel-containing chemotherapy in uterine adenocarcinoma. Ann Oncol. 8:969–972. 1997. View Article : Google Scholar : PubMed/NCBI
25.	Benedetti-Panici P, Greggi S, Scambia G, Salerno MG, Amoroso M, Maneschi F, Cutillo G, Caruso A, Capelli A and Mancuso S: Locally advanced cervical adenocarcinoma: is there a place for chemo-surgical treatment? Gynecol Oncol. 61:44–49. 1996. View Article : Google Scholar : PubMed/NCBI