| Cervical cancer is the third most commonly diagnosed cancer and it posedgreat threats to the health of the female. Besides, it’s a puzzle to treat locallyadvanced cervical cancer (LACC) with high risk factors and poor prognosiswhich is hard to take operation as well as easy to become recurrence andmetastasis. This article summarized the relevant pathogenic factors, pathologicaltypes, clinical stages and therapeutic principle for cervical cancer. We studiedthe main treatment of LACC via reviewing the literature recent years, such assurgical therapy directly, concurrent chemo-radiotherapy, neoadjuvantchemotherapy (NACT) followed by surgery, NACT followed by radiotherapy,radiotherapy followed by surgery. The history and development of NACT as thetreatment of cervical cancer also was roundup, for example, common scheduleof NACT and its outcome, improvement of quality of life, application inpreservation of fertility and treatment for pregnancy complicating uterine cervixcancer, prediction the sensitivity for chemotherapy and so on. On the whole,NACT was potential for future investigation, while its long-term effects wascontroversy. More large-sized randomized double-blind controlled trials wererequired to validate it. Objective: To compare the short-term effectiveness and tolerability ofirinotecan plus cisplatin with palitaxel plus cisplatin as neoadjuvantchemotherapy (NACT) for locally advanced cervical cancer (LACC), and learnmore about the efficacy and safety of irinotecan for the treatment of cervicalcancer.Method: In all,130patients were randomized to the treatment group(irinotecan60mg/m2, d1, d8, d15+cisplatin60mg/m2, d1, n=65), or controlgroup (paclitaxel175mg/m2, d1+cisplatin60mg/m2, d1, n=65), treated byNACT1~2cycles, then followed by radical surgery. The clinical efficacy,pathological outcomes, adverse reaction and quality of life (QOL) between twogroups would be contrasted via statistical analysis.Result: Totally126patients included in the primary analysis,62patients oftreatment group showed an overall response rate (ORR) of79.0%(95% confidence interval [CI],74.5%~84.5%), and none of them had becomeprogression disease. On the other hand, the ORR of control group was68.8%(95%CI,63.0%~74.6%), and one patient was observed progression disease.Grade3~4toxicity, QOL before or after therapy between two groups has nosignificant difference.Conclusion: Irinotecan plus cisplatin as neoadjuvant chemotherapy forLACC performed a promising response rate, and it has no significant differencewith the region of paclitaxel plus cisplatin. Moreover, the toxicity of irinotecanwas tolerated. Objective: To assess the efficacy and safety of irinotecan as neoadjuvantchemotherapy (NACT) for locally advanced cervical cancer (LACC), and learnmore about the current application of irinotecan for cervical cancer, whichwould give a guidance for the future studies.Method: We comprehensive collected current studies about NACT withirinotecan in cervical cancer by computer and manual searches. And table wouldbe drawn to summarize the characteristics of the studies, clinical effectivenessand the main toxicity. If the homogeneity of the studies were fit, the outcome ofresponse rates would be pooled and the quality of them would be evaluated.Result: Totally12studies (517patients) were included,5Chinese studiesand7English studies. Among them, one study was randomized controlled trial,six studies were prospective observational investigations, and three were phaseⅡ clinical trials, one was retrospective research, one was case-control study.There was no meta-analysis because of the heterogeneity. The overall responserate of NACT combined irinotecan for LACC was ranged65%~91.7%. Toxicitiyof grade3~4mainly contained leucopenia, neutropenia, anemia, nauseous,vomiting and diarrhea. The included studies were all of poor-quality. Conclusion: Irinotecan as NACT in LACC showed a favourable outcome.These data warrant confirmation with a phase Ⅲ study. |
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