Evre IB2 serviks kanserinde neoadjuvant kemoterapiye cevabı belirleyen faktörler

The factors which is predict the response to neoadjuvant chemotherapy in stage IB2 cervical cancer

Süha ÖZER, Mehmet Faruk KÖSE, İskender KÖG, İltaç KÜÇÜKELÇİ, Nurettin BORAN, Gökhan TULUNAY, Taner TURAN, Nejat ÖZGÜL

Özet

AMAÇ: Bu çalışmada amaç evre IB2 serviks kanserinde NACT’nin sonuçlarını ve bunu belirleyen faktörleri saptamaktı. Materyal ve Metot: NACT almış evre IB2 serviks kanseri olan 36 hastaya ait veriler retrospektif olarak değerlendirildi. Kemoterapi protokolleri cisplatin/5-fluorauracil, cisplatin/UFT and karboplatin/paklitaksel’di. NACT sonrası hastalar tekrar muayene edildi ve 40mm’nin altında tümörü olan hastalar opere edildi (tip III radikal histerektomi), diğerlerine radioterapi verildi. SONUÇLAR: Hastaların ortalama yaşı 46.3 yıldı ve ortalama takip süresi 46.5 aydı. Ortalama tümör boyutu NACT’den önce 51.4mm, NACT’den sonra 32.7mm’ydi. Toplam klinik cevap 12 hastada (%33.3) elde edilirken, dört hastada (%11.1) tam klinik cevap, 22 hastada (%61.1) stabil hastalık ve iki hastada (%5.6) progresyon saptandı. Yaş (≤45 vs >45) klinik cevabı belirlemekteydi. Tedavi öncesi tümör boyutu, histopatoloji, kemoterapi protokolü ve kemoterapi kür sayısı cevabı etkilememekteydi.TARTIŞMA: Bu çalışmada sadece yaşın NACT’nin etkinliğini belirlediği saptandı. Bu tedavi şeklinin başarısını belirleyen faktörlerin bilinmesi NACT’nin etkinliğini arttıracaktır.

Abstract

INTRODUCTION: The aim of the study was to determine the outcomes of neoadjuvant chemotherapy and its predicting factors in patients with stage IB2 cervical cancer. MATERIALS-METHODS: The data of 36 patients with stage IB2 cervix carcinoma who received neoadjuvant chemotherapy are retrospectively reviewed. Chemotherapy protocols were cisplatin/5-fluorauracil, cisplatin/UFT and carboplatin/paclitaxel. After NACT, the patients were re-examined and the patients who had a tumor size less than 40mm were operated (type III radical hysterectomy) and radiotherapy was given to the others.RESULTS: The mean age of patients was 46.3 years and the mean follow up was 46.5 months. The mean tumor size was 51.4mm before NACT and 32.7mm after NACT. While 12 patients (33.3%) had overall clinical response, complete clinical response was in four (11.1%), stabile disease was in 22 (61.1%) and progression was seen in two (5.6%). Clinical response was affected by age (≤45 vs >45). Tumor size before treatment, histopathology, chemotherapy protocol and the number of chemotherapy course hadn’t an effect on response.CONCLUSION: In this study, the success of NACT was affected by age. The identifying of factors which is determines to outcome of this treatment modality improves the effectiveness of NACT.