Objective: To evaluate the efficacy and toxicity of the combination chemotherapy of irinotecan hydrochloride plus cisplatin on cervical cancer.
Methods: Forty-six patients with cervical cancer, 43 with squamous cell carcinoma, 2 adenocarcinoma, and 1 small cell carcinoma, 41 being treated initially and 5 being recurrent cases of which 2 had undergone radiotherapy plus chemotherapy, 2 radical hysterectomy plus pelvic radiotherapy after operation, and 1 radical hysterectomy plus chemotherapy, aged 38 (22-61), were treated with irinotecan hydrochloride, 60 mg/m(2) in 250 ml normal saline administered on days 1, 8, and 15 by intravenous infusion over 60 min, plus cisplatin, 60 mg/m(2) in 500 ml 5% glucose given on day 1. This regimen was repeated every 28 days. Effectiveness evaluation was conducted after 1-2 courses for the initially treated patients and after 2-6 courses for the recurrent patients.
Results: Totally 79 courses of treatment were given to the 41 patients. After 1-2 courses 4 (9.8%) of the 41 stage Ib2-IIIb initially treated patients achieved complete remission, 30 (73.2%) achieved partial remission, and 7 (17.1%) remained at stationary phase with a overall effective rate of 82.9%. Of the 29 IIb and IIIb stage advanced patients who failed to receive operation originally 20 patients (69%) succeeded to be treated by radical hysterectomy after 1 to 2 courses when the tumorless space between the uterine and the pelvic wall > or = 3 cm with an operatibility rate of 69%. Of the 5 recurrent patients 1 case achieved complete remission, 2 partial remission, and 2 remained stable; none progression of disease was observed after 4-6 courses. The main toxic response and side effect included myelosuppression and diarrhea.
Conclusion: Effective neoadjuvant chemotherapy on cervical cancer, combination therapy of irinotecan hydrochloride and cisplatin win opportunity for treatment and improves their life quality with tolerable side effects.