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Cervical adenocarcinoma treated with docetaxel and carboplatin
International Journal of Gynecology and Obstetrics 83 (2003) 209–210
Brief communication
Cervical adenocarcinoma treated with docetaxel and carboplatin H. Oguri*, N. Maeda, T. Fukaya Department of Obstetrics and Gynecology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, Japan Received 15 April 2003; received in revised form 9 June 2003; accepted 11 June 2003 Keywords: Cervical cancer; Adenocarcinoma; Chemotherapy; Docetaxel; Carboplatin
Although recent reports have discussed the effectiveness of chemoradiotherapy and chemotherapy for patients with cervical cancer w1,2x, an optimal standardized chemotherapy regimen has yet to be established. This report details a case of advanced cervical adenocarcinoma treated with docetaxel and carboplatin. A 49-year-old Japanese woman with vaginal bleeding and lower abdominal distension was referred to our hospital. Vaginal examination allowed the visualization of a carcinomatous tumor occupying the uterine cervix and posterior vaginal fornix. Cervical biopsy revealed a histological diagnosis of adenocarcinoma, with invasion of the rectal mucosa. Endometrial cytology was negative. Magnetic resonance imaging (MRI) demonstrated a huge mass attached to the uterine cervix, measuring 7=9=9 cm in size (Fig. 1). Although computed tomography (CT) did not indicate metastases in the lung and liver, paraaortic lymph node swelling and ascites were noted. Bone scintigraphy and X-ray studies revealed metastasis to the left thighbone. Using guidelines of the Inter*Corresponding author. Tel.: q81-88-880-2383; fax: q8188-880-2384. E-mail address: [email protected] (H. Oguri).
national Federation of Gynecology and Obstetrics, the patient was diagnosed with stage IVB cervical cancer. After obtaining the patient’s informed consent, initial treatment was instituted, consisting of four chemotherapy cycles q 23 day, utilizing docetaxel (taxotere injection, Aventis pharma, Strasbourg, France) 70 mgym2 (i.v., day 1) and carboplatin (Palaplatin, Bristol-Myers Squib Company, New York, USA) at AUC 5 (i.v., day 1). Thrombocytopenia was grade 1–2 and neutrocytopenia was grade 1–3 according to criteria of the Japan Clinical Oncology Group. MRI and CT were performed after the third course of chemotherapy. On MRI, the huge tumor had regressed significantly (rate of reduction: 85.6%). CT imaging revealed no paraaortic lymph node swelling or ascites, and no other abnormal findings were found. Upon completion of chemotherapy, a total of 63 Gy chemoradiotherapy treatments were performed over the course of 8 weeks. On MRI and CT imaging status-post chemoradiotherapy, previously visualized tumors in the pelvic cavity were no longer visible. CT imaging, however, revealed multiple metastasis to the lungs and liver. The patient died from extensive metastasis 57 days after the completion of chemoradiation therapy. In this case, we treated a patient with advanced cervical adenocarcinoma using combined docetax-
0020-7292/03/$30.00 䊚 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/S0020-7292(03)00267-4
210
H. Oguri et al. / International Journal of Gynecology and Obstetrics 83 (2003) 209–210
Fig. 1. Magnetic resonance imaging of the pelvis prior to therapy. Unenhanced sagittal spin echo T2-weighted images demonstrate a huge mass attached to the uterine cervix.
el and carboplatin chemotherapy. Although ultimately the patient died from extensive metastasis, the combined chemotherapy caused significant tumor regression and resolution of ascites. Hematologic and other toxicities of the treatment were well tolerated by the patient. We suggest that combination chemotherapy may be an efficacious choice for the treatment of patients with advanced cervical adenocarcinoma.
References w1x Department of Health and Human Services. NCI Clinical Announcement. Bethesda, MD: Public Health Service, National Institutes of Health, 1999. w2x Rein DT, Kurbacher CM, Breidenbach M, Schondorf T, Schmidt T, Konig E, et al. Weekly carboplatin and docetaxel for locally advanced primary and recurrent cervical cancer: a phase I study. Gynecol Oncol 2002;87(1):98 –103.
Brief communication
Cervical adenocarcinoma treated with docetaxel and carboplatin H. Oguri*, N. Maeda, T. Fukaya Department of Obstetrics and Gynecology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, Japan Received 15 April 2003; received in revised form 9 June 2003; accepted 11 June 2003 Keywords: Cervical cancer; Adenocarcinoma; Chemotherapy; Docetaxel; Carboplatin
Although recent reports have discussed the effectiveness of chemoradiotherapy and chemotherapy for patients with cervical cancer w1,2x, an optimal standardized chemotherapy regimen has yet to be established. This report details a case of advanced cervical adenocarcinoma treated with docetaxel and carboplatin. A 49-year-old Japanese woman with vaginal bleeding and lower abdominal distension was referred to our hospital. Vaginal examination allowed the visualization of a carcinomatous tumor occupying the uterine cervix and posterior vaginal fornix. Cervical biopsy revealed a histological diagnosis of adenocarcinoma, with invasion of the rectal mucosa. Endometrial cytology was negative. Magnetic resonance imaging (MRI) demonstrated a huge mass attached to the uterine cervix, measuring 7=9=9 cm in size (Fig. 1). Although computed tomography (CT) did not indicate metastases in the lung and liver, paraaortic lymph node swelling and ascites were noted. Bone scintigraphy and X-ray studies revealed metastasis to the left thighbone. Using guidelines of the Inter*Corresponding author. Tel.: q81-88-880-2383; fax: q8188-880-2384. E-mail address: [email protected] (H. Oguri).
national Federation of Gynecology and Obstetrics, the patient was diagnosed with stage IVB cervical cancer. After obtaining the patient’s informed consent, initial treatment was instituted, consisting of four chemotherapy cycles q 23 day, utilizing docetaxel (taxotere injection, Aventis pharma, Strasbourg, France) 70 mgym2 (i.v., day 1) and carboplatin (Palaplatin, Bristol-Myers Squib Company, New York, USA) at AUC 5 (i.v., day 1). Thrombocytopenia was grade 1–2 and neutrocytopenia was grade 1–3 according to criteria of the Japan Clinical Oncology Group. MRI and CT were performed after the third course of chemotherapy. On MRI, the huge tumor had regressed significantly (rate of reduction: 85.6%). CT imaging revealed no paraaortic lymph node swelling or ascites, and no other abnormal findings were found. Upon completion of chemotherapy, a total of 63 Gy chemoradiotherapy treatments were performed over the course of 8 weeks. On MRI and CT imaging status-post chemoradiotherapy, previously visualized tumors in the pelvic cavity were no longer visible. CT imaging, however, revealed multiple metastasis to the lungs and liver. The patient died from extensive metastasis 57 days after the completion of chemoradiation therapy. In this case, we treated a patient with advanced cervical adenocarcinoma using combined docetax-
0020-7292/03/$30.00 䊚 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/S0020-7292(03)00267-4
210
H. Oguri et al. / International Journal of Gynecology and Obstetrics 83 (2003) 209–210
Fig. 1. Magnetic resonance imaging of the pelvis prior to therapy. Unenhanced sagittal spin echo T2-weighted images demonstrate a huge mass attached to the uterine cervix.
el and carboplatin chemotherapy. Although ultimately the patient died from extensive metastasis, the combined chemotherapy caused significant tumor regression and resolution of ascites. Hematologic and other toxicities of the treatment were well tolerated by the patient. We suggest that combination chemotherapy may be an efficacious choice for the treatment of patients with advanced cervical adenocarcinoma.
References w1x Department of Health and Human Services. NCI Clinical Announcement. Bethesda, MD: Public Health Service, National Institutes of Health, 1999. w2x Rein DT, Kurbacher CM, Breidenbach M, Schondorf T, Schmidt T, Konig E, et al. Weekly carboplatin and docetaxel for locally advanced primary and recurrent cervical cancer: a phase I study. Gynecol Oncol 2002;87(1):98 –103.