Vol.54 No.3 May 2006
Gynecologic Cancers
Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine,
19-1 Uchimaru, Morioka, Iwate, Japan
Abstract
The standard chemotherapy for gynecologic malignancy consists of topoisomerase I inhibitor and anthracycline using the platinum and taxane as key drugs. The standard therapies for major gynecologic malignancies including ovarian cancer, uterine cervix cancer and uterine corpus cancer in 2005 are briefly mentioned below.
1. Ovarian cancer: The initial therapy is a surgery including a standard surgery and staging laparotomy. Additionally, cytoreductive surgery is performed for advanced cancer. The postoperative chemotherapy is performed with paclitaxel 175 mg/m2/3h+carboplatin AUC 5-6 (TC therapy). Three to six courses and six courses are performed for the stage I cancer and advanced cancer, respectively. Docetaxel and irinotecan can be also used depending on the toxicity and histological subtypes. At the time of recurrence, a regimen that is the same as or similar to the initial regimen is performed for chemosensitive tumor with a longer treatment-free interval (TFI>six months), and novel drugs which are not cross-resistant to the initial therapeutic agents are used for patients with chemoresistant tumor (TFI<six months).
2. Uterine corpus cancer: Radiation therapy is the standard for high-risk cases after the primary surgery in Europe and the U.S. Meanwhile, in Japan, chemotherapies are performed in many facilities for high-risk cases. The standard agents include cisplatin, doxorubicin and paclitaxel. The standard regimen is AP (cisplatin/doxorubicin) therapy. Recently, TAP (cisplatin/doxorubicin/paclitaxel) + G-CSF and TC (paclitaxel/carboplatin) are frequently discussed.
3. Uterine cervix cancer: Chemoradiation is the standard for the stage Ib2 or later in Europe and the U.S. Meanwhile, in Japan, basically, a surgery is performed for up to the stage IIb, neoadjuvant chemotherapy+radical hysterectomy is performed for the stage Ib2 to IIb with bulky mass, and chemoradiation using cisplatin is widely performed for the stage III/IV based on the evidence of Europe and the U.S.
Key word
ovarian cancer, cervical cancer, endometrial cancer, standard treatment, chemotherapy
Received
August 29, 2005
Accepted
April 3, 2006
Jpn. J. Chemother. 54 (3): 239-248, 2006
