Studies on oral-adjuvant chemotherapy of uterine cervical cancer after surgical treatment
Maeda, T.
Nihon Sanka Fujinka Gakkai Zasshi 38(9): 1515-1526
1986
ISSN/ISBN: 0300-9165 PMID: 3095465 Document Number: 268508
To improve the postoperative survival rate of patients with cervical cancer, those with clinical stage Ib or above were treated with adjuvant chemotherapy (oral Tegafur). The drug sensitivity of cultured cervical epidermoid cancer cells was tested with 5-fluorouracil (5-FU), an active derivative of Tegafur. The cumulative rate of recurrence of the group treated with adjuvant chemotherapy was 28.4% (19/67 cases), significantly lower than that of the untreated control group 69.8% (44/63 cases) (p less than 0.01). The rate of recurrence for the two groups was evaluated with Cox's regression models. The rate of recurrence of the treated group was about 50% that of the untreated group. The drug sensitivity of the cultured cancer cells was investigated with a colony forming assay, and a dose-response curve was obtained for the time-dependent anticancer drug. The inhibition of DNA synthesis peaked after 24 to 72 hours of incubation with 5-FU at 0.1 to 0.5 micrograms/ml, but the peak appeared in 4 to 8 hours at 1.0 to 10.0 micrograms/ml. Morphologic changes occurred after 192 hours of incubation at 0.1 microgram/ml. Investigation of the drug sensitivity by cell kinetics disclosed prolongation of the cell cycle after 144 hours at 0.1 microgram/ml and inhibition of cell cycle progression after 48 hours at 10.0 micrograms/ml. Thus, adjuvant chemotherapy with Tegafur reduces the rate of recurrence to about 50% in postoperative patients with cervical cancer. This finding was also supported by an experimental study.