Neoadjuvant treatment of locally advanced carcinoma of the uterine cervix with epirubicin, paclitaxel and cisplatin

Giuseppe D'Agostino, Mariagrazia Distefano, Stefano Greggi, MariaGiovanna G. Salerno, Gabriella Ferrandian, Antanella Poerio, Salvatore Mancuso, Giovanni Scambia

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: The present study was conducted to explore whether neoadjuvant chemotherapy with a combination of epirubicin, paclitaxel and cisplatin could improve the operability and pathological response rate in locally advanced cervical cancer patients. Methods: Between April 1996 and July 2000, 42 patients with carcinoma of the uterine cervix, FIGO stage Ib2-IVa, were treated with two or three 21-day cycles of an epirubicin 100 mg/m2, paclitaxel 175 mg/m2, cisplatin 100 mg/m2 regimen. Results: All patients were eligible for evaluation of toxicity and response. A total of 92 courses of therapy were administered. Three patients had a 20% reduction from the starting dose due to haematological toxicity. Grade 3-4 leukopenia was observed in 15% of cycles, requiring G-CSF support in half of them. Major non-haematological toxicity consisted of grade 3 alopecia (100%), and grade 3 nausea and vomiting (40%). A total of 33 clinical responses (78.5%, 95% CI 63.8-93.2) were recorded, 8 complete responses (CR) and 25 partial responses (PR). Of the 42 patients, 32 (76.2%) underwent radical surgery. At pathological examination 8 complete or microscopic pathological responses, 17 PRs, and 9 patients with stable disease were observed. The median follow-up time was 17 months for the 42 patients enrolled (range 3-62 months). Among the patients submitted to radical surgery, five recurrences were observed, with a median disease-free survival of 47 months. Median overall survival had not been reached at the time of this report. These results appear to be in the range reported for other neoadjuvant cisplatin-based regimens not including paclitaxel. Conclusions: Neoadjuvant chemotherapy with the epirubicin, paclitaxel and cisplatin combination followed by radical surgery proved to be a safe and effective approach to advanced cervical cancer.

Original languageEnglish
Pages (from-to)256-260
Number of pages5
JournalCancer Chemotherapy and Pharmacology
Volume49
Issue number3
DOIs
Publication statusPublished - 2002

Fingerprint

Epirubicin
Neoadjuvant Therapy
Paclitaxel
Cervix Uteri
Cisplatin
Surgery
Carcinoma
Toxicity
Chemotherapy
Granulocyte Colony-Stimulating Factor
Uterine Cervical Neoplasms
Drug Therapy
TP protocol
Alopecia
Leukopenia
Nausea
Disease-Free Survival
Vomiting
Recurrence
Survival

Keywords

  • Cervical cancer
  • Cisplatin
  • Epirubicin
  • Neoadjuvant chemotherapy
  • Paclitaxel

ASJC Scopus subject areas

  • Cancer Research
  • Pharmacology
  • Oncology

Cite this

Neoadjuvant treatment of locally advanced carcinoma of the uterine cervix with epirubicin, paclitaxel and cisplatin. / D'Agostino, Giuseppe; Distefano, Mariagrazia; Greggi, Stefano; Salerno, MariaGiovanna G.; Ferrandian, Gabriella; Poerio, Antanella; Mancuso, Salvatore; Scambia, Giovanni.

In: Cancer Chemotherapy and Pharmacology, Vol. 49, No. 3, 2002, p. 256-260.

Research output: Contribution to journalArticle

D'Agostino, Giuseppe ; Distefano, Mariagrazia ; Greggi, Stefano ; Salerno, MariaGiovanna G. ; Ferrandian, Gabriella ; Poerio, Antanella ; Mancuso, Salvatore ; Scambia, Giovanni. / Neoadjuvant treatment of locally advanced carcinoma of the uterine cervix with epirubicin, paclitaxel and cisplatin. In: Cancer Chemotherapy and Pharmacology. 2002 ; Vol. 49, No. 3. pp. 256-260.
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AU - D'Agostino, Giuseppe

AU - Distefano, Mariagrazia

AU - Greggi, Stefano

AU - Salerno, MariaGiovanna G.

AU - Ferrandian, Gabriella

AU - Poerio, Antanella

AU - Mancuso, Salvatore

AU - Scambia, Giovanni

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AB - Purpose: The present study was conducted to explore whether neoadjuvant chemotherapy with a combination of epirubicin, paclitaxel and cisplatin could improve the operability and pathological response rate in locally advanced cervical cancer patients. Methods: Between April 1996 and July 2000, 42 patients with carcinoma of the uterine cervix, FIGO stage Ib2-IVa, were treated with two or three 21-day cycles of an epirubicin 100 mg/m2, paclitaxel 175 mg/m2, cisplatin 100 mg/m2 regimen. Results: All patients were eligible for evaluation of toxicity and response. A total of 92 courses of therapy were administered. Three patients had a 20% reduction from the starting dose due to haematological toxicity. Grade 3-4 leukopenia was observed in 15% of cycles, requiring G-CSF support in half of them. Major non-haematological toxicity consisted of grade 3 alopecia (100%), and grade 3 nausea and vomiting (40%). A total of 33 clinical responses (78.5%, 95% CI 63.8-93.2) were recorded, 8 complete responses (CR) and 25 partial responses (PR). Of the 42 patients, 32 (76.2%) underwent radical surgery. At pathological examination 8 complete or microscopic pathological responses, 17 PRs, and 9 patients with stable disease were observed. The median follow-up time was 17 months for the 42 patients enrolled (range 3-62 months). Among the patients submitted to radical surgery, five recurrences were observed, with a median disease-free survival of 47 months. Median overall survival had not been reached at the time of this report. These results appear to be in the range reported for other neoadjuvant cisplatin-based regimens not including paclitaxel. Conclusions: Neoadjuvant chemotherapy with the epirubicin, paclitaxel and cisplatin combination followed by radical surgery proved to be a safe and effective approach to advanced cervical cancer.

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KW - Cisplatin

KW - Epirubicin

KW - Neoadjuvant chemotherapy

KW - Paclitaxel

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