Literature DB >> 10697040

Chemotherapy with paclitaxel, ifosfamide, and cisplatin for the treatment of squamous cell cervical cancer: the experience of Monza.

G Zanetta1, F Fei, C Mangioni.   

Abstract

The medical treatment of squamous cell cervical carcinoma is receiving increasing attention. Cisplatin and ifosfamide are known effective drugs. Paclitaxel has been tested with interesting results in cervical cancer. We evaluated the toxic effects and the antitumor activity of a multiagent regimen that included paclitaxel, ifosfamide, and cisplatin (TIP) in two different settings: bulky and locally advanced cervical cancer and recurrent-persistent disease. Treatment consisted of paclitaxel 175 mg/m2 given over 3 hours on day 1, cisplatin 50 mg/m2 (75 mg/m2 in 24 patients), ifosfamide 5 g/m2 and mesna 5 g/m2 given on day 2, and mesna 3 g/m2 given on day 3. In the neoadjuvant setting, the course was repeated every 3 weeks for three courses. Unless there was progression of disease or reason to avoid surgery, all patients were scheduled for radical hysterectomy and pelvic lymphadenectomy. Thirty-eight patients with locally advanced cervical cancer were studied: 11 women achieved a clinical complete response, 21 had a partial response, five had stable disease, and one had disease progression. Among the 34 patients who underwent surgery, six had a pathologically documented complete response, seven had an optimal partial response (only microscopic residual disease), 19 had a suboptimal partial response, and two stable diseases. Grade 3-4 neutropenia was recorded in 71% of patients, grade 3-4 thrombocytopenia in 10.5%, and grade 2 peripheral neuropathy in 2.6%. With a median follow-up period of 22 months for the patients who remain alive, 28 women are alive without recurrence and five are alive with persistent/recurrent disease. Five patients have died of disease. In the salvage setting, 45 women with persistent-recurrent disease after primary treatment were treated; 31 of these women had received prior radiation. In the salvage setting we observed 15 clinical complete responses, 15 partial responses, nine stable diseases, and six disease progressions. The objective response rate was 66.6%. Ten complete responders underwent subsequent surgery and seven had pathologic complete response (two in radiated areas). The response rate was 52% in radiated areas and 75% in nonradiated areas. The median survival time is 6 months for the nonresponders, 9+ month for the partial responders, and 13+ months for the complete responders. The most relevant side effect was myelotoxicity, with 91% of patients experiencing grade 3-4 myelotoxicity. One woman had life-threatening toxicity. This regimen yields a high response rate with acceptable toxicity and should be prospectively compared with other regimens. The high rate of pathologic complete and optimal responses might impact positively on survival, but only a longer follow-up period will allow objective assessment of this impact. The specific roles of paclitaxel and ifosfamide in this regimen remain to be fully understood.

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Year:  2000        PMID: 10697040

Source DB:  PubMed          Journal:  Semin Oncol        ISSN: 0093-7754            Impact factor:   4.929


  16 in total

1.  Dynamic monitoring of apoptosis in chemotherapies with multiple fluorescence reporters.

Authors:  Yunlong Li; Da Xing; Qun Chen
Journal:  Mol Imaging Biol       Date:  2009-01-09       Impact factor: 3.488

2.  Alpha-tocopheryl succinate potentiates the paclitaxel-induced apoptosis through enforced caspase 8 activation in human H460 lung cancer cells.

Authors:  Soo-Jeong Lim; Moon Kyung Choi; Min Jung Kim; Joo Kyoung Kim
Journal:  Exp Mol Med       Date:  2009-10-31       Impact factor: 8.718

Review 3.  The role of radical hysterectomy and neoadjuvant chemotherapy in carcinoma of the cervix.

Authors:  David H Moore
Journal:  Curr Oncol Rep       Date:  2002-03       Impact factor: 5.075

4.  miRNA-34a enhances the sensitivity of gastric cancer cells to treatment with paclitaxel by targeting E2F5.

Authors:  Lina Li; Cuiling Wu; Yue Zhao
Journal:  Oncol Lett       Date:  2017-04-18       Impact factor: 2.967

Review 5.  Gynecologic oncology group trials of chemotherapy for metastatic and recurrent cervical cancer.

Authors:  Krishnansu S Tewari; Bradley J Monk
Journal:  Curr Oncol Rep       Date:  2005-11       Impact factor: 5.075

6.  Glassy cell carcinoma of the uterine cervix responsive to neoadjuvant intraarterial chemotherapy.

Authors:  Tomonori Nagai; Takashi Okubo; Riko Sakaguchi; Hiroyuki Seki; Satoru Takeda
Journal:  Int J Clin Oncol       Date:  2008-12-18       Impact factor: 3.402

7.  Syzygium cumini inhibits growth and induces apoptosis in cervical cancer cell lines: a primary study.

Authors:  D Barh; G Viswanathan
Journal:  Ecancermedicalscience       Date:  2008-08-21

8.  Role of paclitaxel and cisplatin as the neoadjuvant treatment for locally advanced squamous cell carcinoma of the vulva.

Authors:  Francesco Raspagliesi; Flavia Zanaboni; Fabio Martinelli; Santiago Scasso; Joel Laufer; Antonino Ditto
Journal:  J Gynecol Oncol       Date:  2014-01-08       Impact factor: 4.401

9.  Curcumin improves the paclitaxel-induced apoptosis of HPV-positive human cervical cancer cells via the NF-κB-p53-caspase-3 pathway.

Authors:  Yu-Ping Dang; Xiao-Ying Yuan; Rong Tian; Dong-Guang Li; Wei Liu
Journal:  Exp Ther Med       Date:  2015-01-29       Impact factor: 2.447

10.  Novel approaches for concurrent irradiation in locally advanced cervical cancer: platinum combinations, non-platinum-containing regimens, and molecular targeted agents.

Authors:  Giannis Mountzios; Aspasia Soultati; Dimitrios Pectasides; Meletios A Dimopoulos; Christos A Papadimitriou
Journal:  Obstet Gynecol Int       Date:  2013-05-21
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