Carcinoma Avançado do Colo do Útero: Tratamento Inicial pela Quimioterapia

Authors

  • Jurandyr Moreira de Andrade Departamento de Ginecologia e Obstetrícia - Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Universidade de São Paulo (USP). São Paulo (SP), Brasil
  • Heitor Ricardo Cosiski Marana Departamento de Ginecologia e Obstetrícia - Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Universidade de São Paulo (USP). São Paulo (SP), Brasil
  • Maria Angeles S. L. Velludo Departamento de Ginecologia e Obstetrícia - Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Universidade de São Paulo (USP). São Paulo (SP), Brasil
  • Sérgio Bighetti Departamento de Ginecologia e Obstetrícia - Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Universidade de São Paulo (USP). São Paulo (SP), Brasil

DOI:

https://doi.org/10.32635/2176-9745.RBC.1994v40n4.3000

Keywords:

Quimioterapia e Carcinoma do Colo do Útero, Carcinoma do Colo do Útero, Carcinoma Avançado do Colo do Útero, Tratamento Neoadjuvante

Abstract

A new approach to the treatment of advanced cervical carcinoma was utilized in order to make patients operable. Forty patients in stages lla, llb and II Ib ofthe disease were initially treated with chemotherapy (cisplatinum 80-100/m2/cycle and bleomycin 15 mg/cycle) followed by radiotherapy. After combined treatment, 21 patients could be operated upon (12 Wertheim Meigs and nine pan-hysterectomies), without further complications. 85.7% of the operated tumors were exophytic, andonly 19.3% endophiticus. No residual tumors were foundin eight patients (21.7%> ofthe cases). Samples obtained by pelvic lymphadenectomy revealed a low percentage of nodular metastasis (16.7%). Two patients who died and one who had a recurrence on the vaginal fornix were from the endophytic group. We conclude that combined chemotherapy and radiotherapy were effective in rendering more than half the patients susceptible to surgery. Exophytic tumors had the best prognosis in terms of clinical response and disease-free survival. Chemotherapy probably reduced the percentage of pelvic node metastasis.

Downloads

Download data is not yet available.

References

ORGANIZAÇÃO PAN-AMERICANA DE SAÚDE. Manual de Normas e Procedimentos para Controle do Cancer Cérvico-uterino 1985; O.P.A. n»6pp. 9-14.

SOUHAMI L, GIL RA, ALL7N SE et al. A randomized trial of chemotherapy followed by pelvic radiation therapy ih stage lll-b carcinoma of the cervix. J Clin Oncol 1991; 9: 970-977. DOI: https://doi.org/10.1200/JCO.1991.9.6.970

BRUMINI R. Cancer Brasil, Dados Histopatológicos, Rio de Janeiro: Campanha Nacional de Combate ao Cancer, Ministério da Saúde, 1982.

SOUHAMI L, MELO JAC, PAREJA G. The treatment of stage III carcinoma of the uterine cervix with telecobait irradiation. Gynecol Oncol 1987; 28: 262-267. DOI: https://doi.org/10.1016/0090-8258(87)90171-5

FRIEDLANDER ML, KEYE SB, SULLIVAN A et al. Cervical carcinoma: A drug responsive tumor - experience with combined cisplatin, vinblastine and bleomicin. Therapy Gynecol Oncol 1983; DOI: https://doi.org/10.1016/0090-8258(83)90102-6

:275-281.

KIM DS, MOON H, HWANG YY, CHO SH. Preoperative adjuvante chemotherapy in the treatment of cervical cancer stage Ib, lla, and llb with Bulkey tumor. Gynecol Oncol 1988; 29(3): 321-332. DOI: https://doi.org/10.1016/0090-8258(88)90231-4

KUCHNLE H, MEERPOHL HG, EIERMANN W, ACHTERRATH W. Neoadjuvant therapy for cervical cancer. Sem Oncol 1992; 19 (suppl.) 1: 94-98.

PANICI PB, SCAMBIAG, GREGGI S, Dl ROBERTO P, BAIOCCHI G, MANCUSO S. Neoadjuvant chemotherapy and radical surgery in locally advanced cervical carcinoma. A pilot study. Obstet Gynecol 1988; 71 (3): 344-348.

RUSTIN GJS, NEWLAiNDS ES, SOUTHCATT BM, SINGER A. Cisplatin, vincristine, methotrexate and bleomycin (POMB) asinitial or palliative chemotherapy for carcinoma of the cervix. Br J Obstet

Gynecol 1987; 94: 1204-1211.

JONES WB. New approaches to high-risk cervical cancer. Advanced. Cervical Cancer. Cancer 1993; 71 (Suppl.): 1451 -1459. DOI: https://doi.org/10.1002/cncr.2820710408

INTERNATIONAL FEDERATION OF GYNECOLOGY AND OBSTETRICS. Report on the results of treatment in gynecological cancer. FIGO 1988; 20: 29-71.

VERA R. Refections on the management of cancer cérvix in developing countries. Int J Radiat Oncol Biol Phys 1982; 8: 953-955, DOI: https://doi.org/10.1016/0360-3016(82)90109-2

OKEN MM, CREECH RH, TORMEY DC, HORTON J, DAVIS TE, McFADDEN ET, CARBONE PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982; 5: 649-655, DOI: https://doi.org/10.1097/00000421-198212000-00014

ROSEN G, CAPARROS, HUVOS AG, KOSLOFFC, NIREMBERG A, CACUIO A et al. Preoperative chemotherapy for osteogenic sarcoma: selection of postoperative adjuvant chemotherapy based on the response of the primary tumor to preoperative chemotherapy. Cancer 1987; 49; 1122-1230, DOI: https://doi.org/10.1002/1097-0142(19820315)49:6<1221::AID-CNCR2820490625>3.0.CO;2-E

VICKW.WALSH JW. WHEELOCKJB, BRUMER WH. CT of the normal and abnormal parametria in cervical Cancer. Am J Roentgen 1984; 143: 597-603. DOI: https://doi.org/10.2214/ajr.143.3.597

BONADONNA G, VALAGUSSA P, ROSSI A, TANCINI G, BRAMBELLAC, ZAMBETTIM etal. (1985). Tenyears experience with CMF based adjuvant chemotherapy in resectable breast Cancer. Breast Cancer Res Treat 1985; 5: 95-115. DOI: https://doi.org/10.1007/BF01805984

KELSEN DP, MINSKEYB, SMITH M, BEITHER J, NIEDJWLECKI D, CHAPMAN Det al. Preoperative therapy for esophageal Cancer: a randomized comparison of chemotherapy versus radiation

therapy. Clln Oncol 1990; 8: 1352-1361. DOI: https://doi.org/10.1200/JCO.1990.8.8.1352

BONOMIP, BLESSING JA, STEHMAN FB, DISAIAPJ, WALTON L, MAJOR FJ. Randomized trial of three cisplatin dose schedules in squamous-celi carcinoma of the cervix: a Gynecological Oncology Group Study. J Clln Oncol 1985; 3:1079-1085. DOI: https://doi.org/10.1200/JCO.1985.3.8.1079

BLOCH B, NELCP, KRIELA, ATAD J, GOLBERG G. Combination chemotherapy wlth cisplatin and bleomycin in advanced cervical Cancer. Cancer Treat Rep 1984; 68: 891-893.

DAGHESTANI AN, HAKES TB, LYNCH G, LEWIS JL Jr. Cervix carcinoma treatment with combination cisplatin and bleomycin, Gynecol Oncol 1983; 16: 334-339. DOI: https://doi.org/10.1016/0090-8258(83)90159-2

SOUEN JS. Cancer do colo uterino. Tratamento e prognóstico. In: Haibe H. 13 ed. Tratado de Ginecologia. Haibe H 1989:1526-1531.

RUSSEL AH, BURT AR, EK M et al. Adjunctive hysterectomy followlng radiation therapy for bulky carcinoma of the uterine cervix: prognostic implications of tumor persistence. Gynecol Oncol 1987; 28: 200-225. DOI: https://doi.org/10.1016/0090-8258(87)90217-4

WHEELER JA, ZAGARS GK, AYALA AG. Dedifferentiation of locally recurrent prostate Cancer after radiation therapy. Cancer 1993; 71:378 3-3787, DOI: https://doi.org/10.1002/1097-0142(19930601)71:11<3783::AID-CNCR2820711149>3.0.CO;2-X

VOKES EE, SCHILSKYRL, WEICHSELBAUM RR, KOZLOFF MF, PANJE WR. Induction chemotherapy with cisplatin fluorouracil, and high-dose leucovorin for locally advanced head and neck Cancer. J Clin Oncol 1990; 8: 241 -247, DOI: https://doi.org/10.1200/JCO.1990.8.2.241

Downloads

Published

2023-06-05

How to Cite

1.
Andrade JM de, Marana HRC, Velludo MASL, Bighetti S. Carcinoma Avançado do Colo do Útero: Tratamento Inicial pela Quimioterapia. Rev. Bras. Cancerol. [Internet]. 2023 Jun. 5 [cited 2024 May 18];40(4):191-5. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/3000

Issue

Vol. 40 No. 4 (1994): Oct./Nov./Dec.

Section

ORIGINAL ARTICLE

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Most read articles by the same author(s)