RESUMO
Twenty-eight patients with squamous carcinoma of the cervix FIGO stage Ib were treated with three courses of neoadjuvant chemotherapy with a VBP modified scheme. Clinical responses showed that the percentage of complete and moderate responses exceeds 95% of the cases. Clinical response was also related to tumor bulk measurement by ultrasound scanning. Twenty-three of the patients were then subjected to the Wertheim-Meigs operation. Pathological findings of surgical specimens showed absence of residual lesion in 6 patients (26.1%) and carcinoma smaller than 0.5 cm in 5 patients (21.7%). Tumor response to neoadjuvant chemotherapy was excellent in NG3, MG3 tumors when lymphoplasmomonocytic infiltration was present. In accord with this result a new protocol was developed.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias do Colo do Útero/cirurgia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/patologia , Terapia Combinada , Feminino , Humanos , Métodos , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias do Colo do Útero/patologiaRESUMO
Results of a Phase II trial with neoadjuvant chemotherapy in carcinoma of the cervix uteri (VBP modified scheme) show that 85.7% of patients given this therapy were NED in Stage IIb versus 54% of a nonrandomized control group given conventional therapy. In Stage IIIb the averages are 66.6% vs. 31% in the control group. Analysis of the ecographic data has shown that if a critical prechemotherapy volume (120 cm3) is exceeded, the prognosis is unfavorable, especially in cases treated with radiotherapy as second-line treatment.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Recidiva Local de Neoplasia , Neoplasias do Colo do Útero/tratamento farmacológico , Bleomicina/administração & dosagem , Cisplatino/administração & dosagem , Ensaios Clínicos como Assunto , Terapia Combinada , Feminino , Humanos , Estadiamento de Neoplasias , Prognóstico , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/radioterapia , Neoplasias do Colo do Útero/cirurgia , Vimblastina/administração & dosagemRESUMO
Thirty-three patients with locally advanced carcinoma of the cervix were treated with chemotherapy as first line treatment. Great emphasis was applied to document, in the most objective manner, the tumor size response. The first 8 patients received a conventional scheme composed of vincristine, bleomycin and cis-platinum (VBP) at 21-day intervals. The results were not as satisfactory as expected. In the other 25 patients a more aggressive VBP scheme was used, at 10-day intervals. Surprisingly satisfactory results and tolerance were observed. In many instances verified tumor reduction allowed surgical radical treatment in prechemotherapy inoperable cases.