Tratamento do Câncer do Colo do útero Estádio III com Adriamicina, Bleomicina e Cispiatinum (ABC) Neo-adjuvante, Histerectomia Radical Modificada e ABC Adjuvante
DOI:
https://doi.org/10.32635/2176-9745.RBC.1987v33n2.3193Keywords:
Uterine Cervical Neoplasms/therapy, Antineoplastic Agents, Doxorubicin, HysterectomyAbstract
Forty-eight patients (pts) with untreated carcinoma of the cervix stage IIIA and IIIB were subrnitted to 3 to 5 cycles of a combination of adriamycin (ADR), bleomycin (Bleo) and cisplatinum (CDDP), followed by modified radical hysterectomy and adjuvant chemotherapy, 6 cycles, of the sarne association. Forty pts were considered elegible. In 17 pts ADR 50mg/m2, Bleo 10mg/d x 5 and CDDP 100mg/m2were used every 3 weeks. Since unacceptable toxicity was observed in that group, doses of CDDP and Bleo were reduced to 50mg/m2and 6mg/d x 5 in the remaining 23 pts. The response rate obtained in the high dose group (DA) was 88% (15/17) with 5 CR, and the rate obtained with the low dose group (DB) was 79% (78/23), with 3 CF? (p <0,70 N.S.). From 17 pts of DA, 12 (70%) were elegible for surgery Hístopathology showed CR in 2pts (11%) and residual disease in 10 (59%). From the 23 pts of the DB, 16(69%) were operated on with CR confirmed in 3 (13%) and residual disease in 13 (56%). After 38 months, in the DA group, 2 pts (12%) presented NED while 4 (23%) are alive with disease, 7(41%) died, 2 (12%) died due to acute toxicity (cardiac and pulmonary), 1(5%) died (unknown cause) and 1(5%) was lost of view In the DB group, in 36 months, 9 pts (39%) presented NED while 7 (30%) are alive with disease, 5 (22%) died and 2(9%) were lost. The survival rate by Kaplan-Meier method in DA group is 29% and in historical control group of 102 pts treated by radiation therapy in the sarne time is 52% (p <0.01) and in the DB group is 63% (p <0.70 N.S.). The results of ABC DB group in 36 months as anal used in life table and compared with controls demonstrate similar results but the ABC DB group had improvements in quality of life. The ABC DA is very toxic and is not recommended. Twenty-eight were submitted to radical histerectomy and 24 received 3 or 6 cicles of ABC. Twenty are alive (71 %) compared with 52% in control group (p = 0,004). This treatment seerns better than RT in carcinoma of cervix stage III, but a larger observation must be performed.
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