Role of induction chemotherapy in invasive cervical cancer

Tchan Kyu Park, Dong Hee Choi, Soo Nyung Kim, Chang Hoon Lee, YoungTae Kim, Gwi Eon Kim, Chang-Ok Suh, Juhn Kyu Loh

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Abstract

The 386 cases of invasive cervical carcinoma treated with radiotherapy atone were statistically analyzed to delineate the high risk factors (HRFs) associated with a significantly high treatment failure rate; they were (1) stages III-IV, (2) lesion ≥4.0 cm, (3) small cell carcinoma or adenocarcinoma, (4) stages I-II with lesion ≥4.0 cm, and (5) lymphographic evidence of nodal metastasis. Then, chemoradiotherapy (induction chemotherapy plus subsequent radiotherapy) was instituted to 113 invasive cervical carcinoma patients with at least one such HRF. Each patient received two to three cycles of induction chemotherapy at about 3-week intervals. For squamous cell carcinoma, cisplatin, 100 mg/m2 iv, was followed immediately by 5-fluorouracil, 1000 mg/m2, as a 24-hr iv infusion × 5 days. For adenocarcinoma, cisplatin, 70 mg/m2 iv, on Day 1 was followed by cytoxan, 250 mg/m2, on Day 2, and adriamycin, 45 mg/m2, on Day 3. Five-year survival of these patients according to each HRF, in the above order, was 69.1, 67.2, 68.1, 78.3, and 79.5% after chemoradiotherapy, all significantly higher than 57.4, 53.0, 54.5, 48.0, and 48.8% by radiotherapy alone. Drug toxicities such as leukopenia, hepatotoxicity, nephrotoxicity, and hypomagnesemia were seen in 46.5, 53.2, 47.1, and 55.4 % of all cycles, respectively. The toxicities altered drug schedule in 191 (61.2%) ongoing induction chemotherapy cycles. Our cisplatin-based induction chemotherapy is considered an effective preradiotherapy adjunct that can reduce treatment failure in HRF-associated invasive cervical Carcinoma.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalGynecologic Oncology
Volume41
Issue number2
DOIs
Publication statusPublished - 1991 Jan 1

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Induction Chemotherapy
Uterine Cervical Neoplasms
Cisplatin
Radiotherapy
Chemoradiotherapy
Drug-Related Side Effects and Adverse Reactions
Treatment Failure
Carcinoma
Adenocarcinoma
Small Cell Carcinoma
Leukopenia
Fluorouracil
Doxorubicin
Cyclophosphamide
Squamous Cell Carcinoma
Appointments and Schedules
Neoplasm Metastasis
Survival

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Park, T. K., Choi, D. H., Kim, S. N., Lee, C. H., Kim, Y., Kim, G. E., ... Loh, J. K. (1991). Role of induction chemotherapy in invasive cervical cancer. Gynecologic Oncology, 41(2), 107-112. https://doi.org/10.1016/0090-8258(91)90267-9
Park, Tchan Kyu ; Choi, Dong Hee ; Kim, Soo Nyung ; Lee, Chang Hoon ; Kim, YoungTae ; Kim, Gwi Eon ; Suh, Chang-Ok ; Loh, Juhn Kyu. / Role of induction chemotherapy in invasive cervical cancer. In: Gynecologic Oncology. 1991 ; Vol. 41, No. 2. pp. 107-112.
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abstract = "The 386 cases of invasive cervical carcinoma treated with radiotherapy atone were statistically analyzed to delineate the high risk factors (HRFs) associated with a significantly high treatment failure rate; they were (1) stages III-IV, (2) lesion ≥4.0 cm, (3) small cell carcinoma or adenocarcinoma, (4) stages I-II with lesion ≥4.0 cm, and (5) lymphographic evidence of nodal metastasis. Then, chemoradiotherapy (induction chemotherapy plus subsequent radiotherapy) was instituted to 113 invasive cervical carcinoma patients with at least one such HRF. Each patient received two to three cycles of induction chemotherapy at about 3-week intervals. For squamous cell carcinoma, cisplatin, 100 mg/m2 iv, was followed immediately by 5-fluorouracil, 1000 mg/m2, as a 24-hr iv infusion × 5 days. For adenocarcinoma, cisplatin, 70 mg/m2 iv, on Day 1 was followed by cytoxan, 250 mg/m2, on Day 2, and adriamycin, 45 mg/m2, on Day 3. Five-year survival of these patients according to each HRF, in the above order, was 69.1, 67.2, 68.1, 78.3, and 79.5{\%} after chemoradiotherapy, all significantly higher than 57.4, 53.0, 54.5, 48.0, and 48.8{\%} by radiotherapy alone. Drug toxicities such as leukopenia, hepatotoxicity, nephrotoxicity, and hypomagnesemia were seen in 46.5, 53.2, 47.1, and 55.4 {\%} of all cycles, respectively. The toxicities altered drug schedule in 191 (61.2{\%}) ongoing induction chemotherapy cycles. Our cisplatin-based induction chemotherapy is considered an effective preradiotherapy adjunct that can reduce treatment failure in HRF-associated invasive cervical Carcinoma.",
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Park, TK, Choi, DH, Kim, SN, Lee, CH, Kim, Y, Kim, GE, Suh, C-O & Loh, JK 1991, 'Role of induction chemotherapy in invasive cervical cancer', Gynecologic Oncology, vol. 41, no. 2, pp. 107-112. https://doi.org/10.1016/0090-8258(91)90267-9

Role of induction chemotherapy in invasive cervical cancer. / Park, Tchan Kyu; Choi, Dong Hee; Kim, Soo Nyung; Lee, Chang Hoon; Kim, YoungTae; Kim, Gwi Eon; Suh, Chang-Ok; Loh, Juhn Kyu.

In: Gynecologic Oncology, Vol. 41, No. 2, 01.01.1991, p. 107-112.

Research output: Contribution to journalArticle

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