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Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for stage IB2, IIA2, and IIB patients with non-squamous cell carcinoma of the uterine cervix

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Abstract

Background

We conducted a phase II study to evaluate the efficacy of neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for patients with non-squamous cell carcinoma of the uterine cervix.

Methods

Sixty-one patients with International Federation of Gynecology and Obstetrics stage IB2, IIA2, or IIB non-squamous cell carcinoma of the uterine cervix were enrolled. The patients were administered docetaxel at a dose of 60 mg/m2, followed by carboplatin at a dose based on an area under the curve of 6. The treatments were repeated every 21 days for one to three cycles. Fifty-two patients were eligible to evaluate the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy. Adverse events were evaluated in 59 patients.

Results

The response rate was 69 % (95 % CI, 57–82 %), with 5 patients achieving complete response, 31 partial response, 15 stable disease, and 1 progressive disease. Median follow-up duration was 1913 days with a range of 145–2632 days. Of 52 patients, 50 underwent radical hysterectomy after neoadjuvant chemotherapy. The 2-year overall survival rate was 81.8 % for stage IB2, 85.7 % for stage IIA2, and 92.6 % for stage IIB. The most frequent grade 3 and 4 hematological toxicity was neutropenia, with 43 patients experiencing grade 4 and 11 with grade 3. The nonhematological toxicities were mainly grade 1 or 2 in severity.

Conclusion

Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy may be a useful strategy for patients with non-squamous cell carcinoma of uterine cervix.

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Acknowledgments

The authors extend their gratitude to the investigators at the participating institutions: Eiji Hirata (Hiroshima University Hospital), Kazuhiro Takehara (National Hospital Organization Kure Medical Center), Ryoji Hayase (Fukuyama Medical Center), Yasunobu Kanamori (Yamaguchi Red Cross Hospital), Akihiro Murakami (Yamaguchi University Hospital), and Hideo Fujimoto (JA Hiroshima Kouseiren Hospital), and Shinya Sato (Tottori University Hospital). The authors also thank the statistician, Tetsutaro Hamano, for his support during the independent statistical analysis.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan

    Muneaki Shimada

  2. Department of Gynecology, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, Hyogo, 673-8558, Japan

    Shoji Nagao & Satoshi Yamaguchi

  3. Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Keiichi Fujiwara

  4. Department of Gynecology, Cancer Institute Hospital, Koto-ku, Tokyo, 135-8550, Japan

    Nobuhiro Takeshima & Ken Takizawa

  5. Department of Obstetrics and Gynecology, Iwate Medical University, 19-1, Uchimaru, Morioka, Iwate, 020-8505, Japan

    Tadahiro Shoji & Toru Sugiyama

  6. Hyogo Prefectural Hospitals Agency, 5-10-1, Shimoyamate-dori, Kobe, Hyogo, 650-8567, Japan

    Ryuichiro Nishimura

  7. Matsue City Hospital, 32-1 Noshiracho, Matsue, Shimane, 690-0045, Japan

    Junzo Kigawa

Authors
  1. Muneaki Shimada
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  2. Shoji Nagao
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  3. Keiichi Fujiwara
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  4. Nobuhiro Takeshima
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  7. Toru Sugiyama
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  9. Ryuichiro Nishimura
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  10. Junzo Kigawa
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Corresponding author

Correspondence to Muneaki Shimada.

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Conflict of interest

Keiichi Fujiwara received research funding from Sanofi-aventis K.K. Toru Sugiyama received honoraria and research funding from Chugai Pharmaceutical Co., Ltd. The other authors have no conflict of interest.

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Shimada, M., Nagao, S., Fujiwara, K. et al. Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for stage IB2, IIA2, and IIB patients with non-squamous cell carcinoma of the uterine cervix. Int J Clin Oncol 21, 1128–1135 (2016). https://doi.org/10.1007/s10147-016-1010-0

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  • DOI: https://doi.org/10.1007/s10147-016-1010-0

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