title: [Combination chemotherapy with 254-S, ifosfamide and peplomycin for advanced or recurrent cervical cancer].
abstract: From favorable results with 254-S, a new cisplatin analogue, single administration, we have conducted a clinical study to investigate the efficacy of combination of 254-S, ifosfamide and peplomycin, each of which has a different dose limiting factor. A total of 45 patients, including 22 patients with stage III and IV cervical cancer and 23 cases with recurrent cervical cancer, were treated with at least two courses of 254-S (100mg/m2, iv. Day 1), ifosfamide (1,500mg/body, iv. Day 1-5) and peplomycin (5mg/body, im. Day 1-6), and tumor response was evaluated clinically and by CT scanning. The response rate obtained in patients with advanced disease was 81.8% (PR = 17, CR = 1) and that in cases with recurrence was 60.9% (PR = 12, CR = 2). Myelosuppression was the dose limiting factor. In the 121 courses, grade 3 and 4 of leucopenia and thrombocytopenia were observed with an incidence of 44% and 32%, respectively and DIC occurred in 3 cases with poor PS though they recovered after reducing the 254-S dose to 80 mg/m2. The other toxicities were mild except for alopecia. Anaphylaxia was observed in a case at the second administration though the patient recovered in 15 minutes. There was no death. As to prognosis, a significant prolongation of survival period was observed in recurrent cases and 4 cases are alive (NED) after one and a half year. In the advanced cases, until now 3 cases of stage IV have died from the disease. We have concluded that this regimen is effective as a neoadjuvant chemotherapy for advanced cervical cancer and useful for the treatment of recurrent cervical cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Fukuyama National Hospital, Hiroshima.
authors.forename: K
authors.initials: K
authors.lastname: Hirabayashi
authors.forename: E
authors.initials: E
authors.lastname: Okada
authors.forename: Y
authors.initials: Y
authors.lastname: Nakazuma
authors.forename: Y
authors.initials: Y
authors.lastname: Akamatsu
authors.forename: H
authors.initials: H
authors.lastname: Sezaki
authors.forename: M
authors.initials: M
authors.lastname: Ohta
authors.forename: Y
authors.initials: Y
authors.lastname: Nakanishi
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D017663:Peplomycin; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy*
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D001761:Bleomycin; D017663:Peplomycin; C053989:nedaplatin; D007069:Ifosfamide