Effect of 13-cis-Retinoic Acid on Chemotherapy of cervical cancer

BACKGROUND : Retinoid are strong inhibitors of epithelial cancer promotion and progression in experimental carcinogenesis. Recently, therapeutic trial of retinoids have demonstrated activites in cervical cancer and precancerous lesion of cervix, Our purpose was to determine whether the administraion of 13-cis-Retinoic Acid is more effectual in the neoadjuvant chemotherapy of cervical carcinoma. METHODS : From January 1994 through January 1995, 40 patients with invasive cervical cancer were enrolled in this prospective study and divided by two groups. group 1 had neoadjuvant chemotherapy plus 13-cis-Retinoic Acid (RA) at a dosage of 1mg/kg/day for 1 month. Patients between group 1 and group 2 were similar with respect to age, parity, clinical stage, and histological subtype. Therapeutic responses were compared using Fisher`s exact test, Mann-Whitney test, and Wilcoxon signed rank test. RESULTS : RA increased the complete response rate of neoadjuvant chemotherapy from 0% in the group 1 to 5% in group 2. but difference of overall response rate between two group was not evident. The drug toxicities between group 1 and group 2 included anemia in 30.0% and 23.7%, leukopenia in 6.7% and 15.2% and hepatotoxicity in 6.7% and 6.8% respectively. More skin side effectes were seen in the patients of group 2, but these effects were mild and reversible. CONCLUSION : It would be suggested that RA plus chemotherapy may be superior chemotherapy alone in increasing the complete response rate of neoadjuvant chemotherapy forpatients with cervical cancer. The impact of such a treatment on survical needs to be futher explored.restrictio