Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement

Wang, Yue; Wang, Guang; Wei, Lihui; Huang, Lumei; Wang, Jianliu; Wang, Shijun; Li, Xiaoping; Shen, Danhua; Bao, Dongmei; Gao, Jian Ming

doi:10.5732/cjc.011.10050

Cited by 20 publications

(20 citation statements)

References 35 publications

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“…In 40 patients undergoing NAC plus radical hysterectomy, median operative time was 260 min and median surgical blood loss was 500 ml, similar to those findings in studies of radical hysterectomy for patients with stage IB2 to IIB with a bulky mass reported by He et al and Wang et al [14, 15]. No serious postoperative complications, such as intestinal obstruction and thrombosis, occurred.…”

Section: Discussionsupporting

confidence: 82%

Phase II clinical study of neoadjuvant chemotherapy with CDDP/CPT-11 regimen in combination with radical hysterectomy for cervical cancer with a bulky mass

et al. 2016

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BackgroundWe examined the efficacy and safety of neoadjuvant chemotherapy (NAC) with the CPT-11 + CDDP regimen in combination with radical hysterectomy.Subjects and methodsThe subjects were 42 patients with stages IB2 to IIIB squamous cell carcinoma of the uterine cervix with a bulky mass. CDDP at 70 mg/m2 was intravenously administered on day 1 and CPT-11 at 70 mg/m2 was intravenously administered on days 1 and 8 of a 21-day cycle. In principle, two cycles were administered followed by radical hysterectomy. We examined antitumor efficacy, adverse events, completion rate of radical hysterectomy, operative time, surgical blood loss, progression-free survival (PFS), and overall survival (OS).ResultsThe antitumor effect was complete response in 7 patients, partial response in 28, stable disease in 6, and progressive disease in 1; the response rate was 83.3 % (95 % confidence interval, 68.6–93.0). Grade 3 or more severe neutropenia, anemia, and platelet count decreases were noted in 23 (54.8 %), 4 (9.5 %), and 1 (2.4 %) patient, respectively. Grade 3 nausea occurred in 3 patients (7.1 %), vomiting in 1 (2.4 %), and grade 3 febrile neutropenia in 2 (7.1 %). The completion rate of radical hysterectomy was 88.1 %. The median operative time and surgical blood loss were 260 min (range, 210–334) and 500 ml (range, 393–898), respectively. The 5-year PFS rate was 67.2 %, and the 5-year OS rate was 68.0 %. In multivariate analysis, lymph node metastasis before NAC [hazard ratio (HR), 34.88] and non-response to NAC (HR 30.58) were significant prognostic factors.ConclusionNAC with the CDDP/CPT-11 regimen achieves a high antitumor efficacy with moderate adverse reactions, allowing safe radical hysterectomy, and is thus considered to be a useful therapeutic method that can improve prognosis.

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Section: Discussionsupporting

confidence: 82%

Phase II clinical study of neoadjuvant chemotherapy with CDDP/CPT-11 regimen in combination with radical hysterectomy for cervical cancer with a bulky mass

et al. 2016

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“…Sixty-eight patients were administered NAC with a base of platinum and then underwent surgery while the remaining 42 patients underwent surgery directly without NAC intervention. In this study 48 out of 68 (70.6%) patients who had prior NAC intervention had complete or partial remission compared to a much smaller response in patients subjected to operation without NAC treatment (Wang et al, 2011).…”

Section: Discussionmentioning

confidence: 54%

“…NAC is also reported to reduce the risk of pathological factors that may be associated with the prognosis for cervical cancer. Wang et al, (2011) cited the review of Guo et al, (2015) in which 110 patients with advanced stage cervical carcinoma underwent a radical hysterectomy with or without NAC. Sixty-eight patients were administered NAC with a base of platinum and then underwent surgery while the remaining 42 patients underwent surgery directly without NAC intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Combination chemotherapy is set individually by an oncologist to consider the function of the heart, liver and kidneys. Wang et al, (2011) used BIP (DDP + bleomycin + ifosfamide) and the PF regimen (DDP + 5fluorouracil). They found NAC in patients with locally advanced cervical cancer had a beneficial effect on local control by improving the chance, and lowering the risks of surgery.…”

Section: Outcome Of Combined Neoadjuvant Chemotherapy and Vitamin A Imentioning

confidence: 99%

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Outcome of Combined Neoadjuvant Chemotherapy and Vitamin A in Advanced Cervical Carcinoma: A Randomized Double-Blind Clinical Trial

Sanusi

2019

Asian Pac J Cancer Prev

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Background:The latest World Health Organization (WHO) inquiry on the epidemiology of cervical cancers indicate there are approximately 528,000 new cases per year, ranking fourth after breast, colorectal and lung cancer. The validity of neoadjuvant chemotherapy (NAC) alone in advanced cervical cancer is still being debated. NAC induces tumor shrinkage prior to pursuing surgery. NAC also has the benefit of sterilizing the lymph nodes and parametria, thereby lowering the need for adjuvant therapy after surgery. This research aims to determine the impact on the treatment of advanced cervical carcinoma with NAC, with the additional provision of Vitamin A during treatment to assess the factors that could affect the outcome of clinical treatment. Methodology:The research methodology and design of this study is a randomized double-blind clinical trial to compare the effects of treatment with NAC and treatment with NAC + Vitamin A, in advanced cervical carcinoma. Both study groups received treatments consisting of a regime of cisplatin and paclitaxel. The study was conducted at the General Hospital of Dr. Mohammad Hoesin. The total number of patients recruited for the trial was 30 with 15 patients per treatment arm. One group received NAC consisting of cisplatin and paclitaxel and the remaining 15 patients received NAC + Vitamin A. Results:The addition of Vitamin A was found to be much better in influencing the clinical response in the treatment of advanced cervical carcinoma, although this was not statistically significant. However, a larger sample size with the reported proportion of higher positive outcome for NAC + Vitamin A may be statistically significant. Conclusion:Based on the results, Vitamin A supplementation in the treatment of advanced cervical carcinoma with neoadjuvant chemotherapy may play a crucial role in the treatment of cervical carcinoma.

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“…The chemotherapies developed to improve treatment outcomes of cervical cancer which including neoadjuvant chemotherapy (NACT) before CCRT and radical hysterectomy [5]. The aim of NACT is improve the prognosis of patients with LACC by shrinking the tumor and killing metastatic cells before further treatment; however, there is currently no standard NACT regimen [6]. The safety of paclitaxel plus carboplatin as a NACT has been demonstrated in many studies [7], with its efficacy against cervical squamous cell carcinoma varying from patient to patient.…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of proteins related to chemoresistance to paclitaxel and carboplatin in human SiHa cervical cancer cells via iTRAQ

Han

Geng

et al. 2020

J Gynecol Oncol

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Objective: This study aimed to identify proteins related to paclitaxel and carboplatin chemoresistance in cervical cancer. Methods: Quantitative proteomic analysis was performed on normal SiHa cells and those treated with paclitaxel and carboplatin for 14 days, with isobaric tags for relative and absolute quantitation (iTRAQ) analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were used to identify related processes and differentially expressed proteins. Results: A total of 67 and 96 differentially expressed proteins were identified in the paclitaxel-and carboplatin-treated groups, respectively. GO and KEGG enrichment analyses identified 53 (43 upregulated and 10 downregulated) and 85 differentially expressed proteins (70 upregulated and 15 downregulated) in the paclitaxel-and carboplatin-treated groups, respectively. The cell counting kit-8 results revealed that APOA1 was overexpressed in both the paclitaxel-and carboplatin-resistant SiHa cells compared with the control cells. Immunohistochemistry showed that APOA1 was highly expressed in the paclitaxel-and carboplatin-resistant squamous cell carcinoma of the cervix. Conclusion: This study is the first to use iTRAQ to identify paclitaxel-and carboplatinresistance proteins in cervical cells. We identified several proteins previously unassociated with paclitaxel and carboplatin resistance in cervical cancer, thereby expanding our understanding of paclitaxel and carboplatin resistance mechanisms. Moreover, these findings indicate that the APOA1 protein could serve as a potential marker for monitoring and predicting paclitaxel and carboplatin resistance levels.

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Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement

Cited by 20 publications

References 35 publications

Phase II clinical study of neoadjuvant chemotherapy with CDDP/CPT-11 regimen in combination with radical hysterectomy for cervical cancer with a bulky mass

Phase II clinical study of neoadjuvant chemotherapy with CDDP/CPT-11 regimen in combination with radical hysterectomy for cervical cancer with a bulky mass

Outcome of Combined Neoadjuvant Chemotherapy and Vitamin A in Advanced Cervical Carcinoma: A Randomized Double-Blind Clinical Trial

Quantitative analysis of proteins related to chemoresistance to paclitaxel and carboplatin in human SiHa cervical cancer cells via iTRAQ

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