title: Vinorelbine as neoadjuvant chemotherapy in advanced cervical carcinoma.
abstract: OBJECTIVE
  To evaluate the efficacy and toxicity of vinorelbine (VNB) as single-agent neoadjuvant chemotherapy in advanced cervical carcinoma (ACC).
  
  
  METHODS
  Between December 1993 and October 1995, 43 untreated patients with stages IIB to IVA squamous cell cervical cancer were entered onto this study. Forty-two patients are assessable for response and 43 for toxicity. The median age was 46 years (range, 28 to 65). Distribution by stages (International Federation of Gynecology and Obstetrics [FIGO]) was as follows: IIB, 18 patients; IIIA, one; IIIB, 19; and IVA, five. Therapy consisted of VNB 30 mg/m2 by 20-minute intravenous (IV) infusion repeated weekly for 12 injections and followed by radical surgery if feasible or definitive radiotherapy. Both staging and response assessment were performed by a multidisciplinary team.
  
  
  RESULTS
  One patient was considered not assessable for response. A total of 493 cycles of therapy were administered and objective remissions were observed in 19 of 42 patients (45%; 95% confidence interval, 30% to 60%). Two patients (5%) had a complete response (CR) and 17 (40%) a partial response (PR); no change (NC) was observed in 16 (38%) and progressive disease (PD) in seven (17%). Six of 19 patients (32%) who achieved objective responses (ORs) underwent surgery. The median time to failure and median survival time have not been reached yet. There were no therapy-related deaths. The dose-limiting toxicity was myelosuppression. Leukopenia occurred in 35 patients (81%) and was grade 3 or 4 in seven (17%). Twelve patients (28%) developed peripheral neuropathy, while myalgias occurred in 10 (23%). Constipation was observed in nine patients (21%), one with a prolonged ileum. Phlebitis was recorded in 18 patients (41%). In contrast, emesis and mucositis were rarely observed. No patient developed alopecia grade 3. By the end of the twelfth course of treatment, the average received dose-intensity was 85.4% of that projected.
  
  
  CONCLUSIONS
  VNB is an active drug against ACC with moderate toxicity. Its activity is among the highest reported for single agents. Further evaluation in association with other agents is clearly justified.
authors.affiliation: Grupo Oncológico Cooperativo del Sur, Neuquen, Républica Argentina. 70501-1204@Compuserve.com
authors.forename: J A
authors.initials: JA
authors.lastname: Lacava
authors.forename: B A
authors.initials: BA
authors.lastname: Leone
authors.forename: M
authors.initials: M
authors.lastname: Machiavelli
authors.forename: A O
authors.initials: AO
authors.lastname: Romero
authors.forename: J E
authors.initials: JE
authors.lastname: Perez
authors.forename: Y L
authors.initials: YL
authors.lastname: Elem
authors.forename: R
authors.initials: R
authors.lastname: Ferreyra
authors.forename: G
authors.initials: G
authors.lastname: Focaccia
authors.forename: G
authors.initials: G
authors.lastname: Suttora
authors.forename: M A
authors.initials: MA
authors.lastname: Salvadori
authors.forename: M A
authors.initials: MA
authors.lastname: Cuevas
authors.forename: L R
authors.initials: LR
authors.lastname: Acuña
authors.forename: J R
authors.initials: JR
authors.lastname: Acuña
authors.forename: M
authors.initials: M
authors.lastname: Langhi
authors.forename: S
authors.initials: S
authors.lastname: Amato
authors.forename: J
authors.initials: J
authors.lastname: Castaldi
authors.forename: A
authors.initials: A
authors.lastname: Arroyo
authors.forename: C T
authors.initials: CT
authors.lastname: Vallejo
mesh_terms: D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D009367:Neoplasm Staging; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077235:Vinorelbine
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014747:Vinblastine; D000077235:Vinorelbine