Chemotherapy for Gynecological Neoplasms: Current Therapy and Novel Approaches

684 Pages·2004·10.331 MB·English

by  R Angioli, et al

CRC Press
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Version Date: 20130813
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5418-2_Angioli_Foreword_R1_042204
Foreword
InwritingtheForewordforthismuch-needed textbook,Ithoughtitappropriateto
relate some of the history leading up to the multi-disciplinary involvement that
currently exists in the chemotherapeutic treatment of gynecologic malignancies. In
the1960s,veryfewchemotherapeuticagentsexistedandhadbeensuccessfullyutilized
inthemanagementofsolidtumorsincludingovarianepithelialcarcinoma.Manage-
mentofasciteswasparticularlytroublesometophysiciansburdenedwiththemanage-
ment of these patients when the use of alkylating agents was shown to be definitely
advantageous.Medicaloncologywas,atthattime,anembryonicfieldemergingfrom
thewell-establishedsubspecialtyofHematologyOncology.IntheUnitedStatesand
elsewhere, gynecologists, particularly interested in the treatment of malignancies of
thegenitaltrack,madeaconsciousdecisiontoembracetheevolvingfieldofchemo-
therapeuticagentsforsolidtumorsandtherebypermitmuch,ifnotall,ofthetherapy
of these afflicted women to rest in the hands of one physician. These were the early
gynecologiconcologistswhofeltthatthephilosophyofoneleadphysicianwouldbein
thebestinterestofthepatients’physicalandemotionalhealth.Now,therearemultiple
disciplines involved in the chemotherapy of gynecologic malignant neoplasms, and
thistextbyAngiolietal.willbehelpfultoall.
The editors begin with a discussion of the Basic Principles of Chemotherapy
which includes some investigative areas such as mechanisms of chemotherapy
resistance,genetherapy,andhighdosechemotherapy.UndertheClinicalAspectsof
Chemotherapysection,theeditorshaveapotpourriofsubjectsrangingfromtheroleof
hormonereplacementtherapyinso-called‘‘estrogensensitive’’malignanciestotheuse
of chemotherapy in the pregnant patient. This section is rather unique in that it is
focused in on problems that may be of special complexity in the patient with a
gynecologiccancer.
The editors then turn to discussing chemotherapy of particular malignancies
grouped by organ site starting with ovarian cancer and going on to fallopian tube
carcinoma, corpus carcinoma, cervical carcinoma, vulvo-vaginal carcinoma, and
gestationaltrophoblasticdisease.
v
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5418-2_Angioli_Foreword_R1_042204
vi Foreword
The authors, for each and every chapter, have selected from a list of world
authorities. The resulting text is a one-of-a-kind resource which I believe every
individualtreatingorcaringforpatientswithgynecologicmalignanciesshouldhave
intheirlibrary.Itiswell-written,itiscurrent,anditis,indeed,comprehensive.
PhilipJ.DiSaia,M.D.
Professor,DepartmentofObstetricsandGynecology
Director,DivisionofGynecologicOncology
UniversityofCalifornia,Irvine
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5418-2_Angioli_Preface_R1_042204
Preface
The idea of a work entirely dedicated to the chemotherapeutic management of
gynecological malignancies evolved from the recognized advances in this field
throughout the last few years in addition to the lack of a well-structured book dis-
cussingthistopic.
Gynecologists,generalsurgeonsandmedicaloncologistsweretypicallyinvolved
in the management of these patients with a mandatory tight collaboration among
specialties.Inthelast40years,however,thesubspecialtyofgynecologiconcologyhas
rapidlygrown.Thissubspecialtyisquiteuniquebecauseitincludesvariousclassical
specialties such as abdominal/pelvis surgery, chemotherapy, radiotherapy, and
molecular biology; moreover, the field of chemotherapy for patients affected by
gynecologictumorsisbecoming highly specialized. Gynecologiconcologists, aswell
asmedicaloncologists,arenowregularlyinvolvedinthedecisionandadministration
ofchemotherapytothesepatients.Theneedforasystematicdiscussionoftheuseof
chemotherapyforgynecologicmalignancieswasobvious.Oneofourmaingoalswas
to include standard therapies, major ongoing trials, and future directions in a very
practicalbook.
Thefirstsectionincludesthebasicprinciplesofchemotherapy,withparticular
emphasistothemechanismofactionofthevariousdrugs,theirinteractioninvitroas
wellasinvivowithotherdrugs,andinteractionwiththehost.Immunotherapy,gene
therapy,andpharmacogenomicsarealsodiscussed.
In the second part of the book, general clinical aspects of chemotherapy are
described.Thissectionbeginswithadescriptionofhowtowriteaclinicalprotocoland
thencontinuestofocusonconceptsapplicabletoanypatientreceivingchemotherapy
(i.e. supportive treatments, management complications, psychological support, pain
management,etc.)
The final sections describe, in detail, the recommended chemotherapeutic
management of cancer for each site organ of the lower female genital tract (ovary,
fallopiantube,uterus,vulva,andvagina).
The various chapters have been written by highly specialized physicians and
scientistsentirelydedicatedtothetopicdescribed.Apanelofinternationalexpertsin
thisfieldwaschosenasauthorsofthevariouschapters.Theclosecollaborationamong
different working groups has allowed this endeavor to be developed using a stan-
dardizedmethod.
vii
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5418-2_Angioli_Preface_R1_042204
viii Preface
Thisbookisdirectedtobasicscientistsintrainingandinvolvedinresearch;itis
dedicatedtocancertreatmentresearchers,medicaloncologists,aswellasgynecologic
oncologistsintrainingandinpractice.Wefindthisbookusefulforbothtrainingand
everydayclinicalmanagement.Wealsofindthisbookusefulforcurrentmanagement
and future approaches for any physician and paramedic dealing with gynecologic
cancerpatients.
RobertoAngioli
PierluigiBenedettiPanici
JohnJ.Kavanagh
SergioPecorelli
ManuelPenalver
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5418-2_Angioli_Contents_R2_042304
Contents
Foreword Philip J. DiSaia v
Preface vii
Contributors xiii
I. Basic Principles of Chemotherapy
1. Antineoplastic Agents: Classification and Mechanisms of Action 1
Rui Aoki and John J. Kavanagh
2. Mechanisms of Chemosensitivity and Resistance 13
Shilpa Gajarawala and Bernd-Uwe Sevin
3. In Vitro Testing for Drug Sensitivity/Resistance 47
Bernd-Uwe Sevin
4. BasicPrinciplesofDoseIntensityandHigh-DoseChemotherapy 57
M. Untch, N. Ditsch, P. Wimberger, V. Mo¨bus, and R. Kimmig
5. Immunotherapy in Gynecologic Malignancies 67
Pedro T. Ramirez and Ralph S. Freedman
6. Gene Therapy of Ovarian Cancer 93
George Coukos and Christina S. Chu
7. Basic Concepts of Chemotherapy Sequence and Combinations 119
Francis Y. Lee and Renzo Canetta
8. Pharmacoeconomic Applications in Gynecologic Oncology 137
Judith A. Smith
II. Clinical Aspects of Chemotherapy
9. Guidelines to Writing a Clinical Protocol 145
Edward L. Trimble
ix
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x Contents
10. Evaluation of Gynecologic Tumor Response: When and How? 173
Noah A. Goldman and Carolyn D. Runowicz
11. Practical Guide on How to Deliver Chemotherapy 187
Antonella Savarese and Francesco Cognetti
12. Evaluation of the Patient for Chemotherapy 201
Groesbeck P. Parham, Michael Hicks, Alessandro D. Santin,
Raleigh Butler, and Mia Cowens
13. Chemotherapy in Pregnancy 207
Christine H. Holschneider, Robert E. Bristow, and F. J. Montz
14. Supportive Treatment in Gynecologic Malignancies 233
G. Marx, S. Yip, C. Steer, and P. Harper
15. Hormone Replacement Therapy in Gynecologic Cancer Patients
and Survivors 245
Wendy R. Brewster and Philip J. DiSaia
16. Infections in Patients with Gynecological Malignancies:
Prevention and Management 257
Shivani Singh and Rodger D. MacArthur
17. Pharmacologic Pain Management in Gynecologic Oncology 275
Wilberto Nieves-Neira, Roberto Angioli, and Manuel Penalver
18. Blood Transfusion During Chemotherapy: Risks and Benefits 297
Alessandro D. Santin and Sergio Pecorelli
19. Role of Tumor Markers in Gynecologic Oncology 307
Andrew Li and Jonathan S. Berek
20. Role of Chemoprotectors During Chemotherapy
for Gynecologic Neoplasms 317
Emery M. Salom and Luis E. Mendez
21. Chemoprevention in Gynecological Oncology 325
Ramin Mirhashemi and Talia Donenberg
22. Role of Psychological Support During Chemotherapy 345
Sabine Hawighorst-Knapstein, Go¨tz Scho¨nefuß,
and Paul G. Knapstein
23. Quality of Life During Chemotherapy: Recent Results and
Methodological Challenges of Conducting Quality-of-Life
Studies with Gynecological Cancer Patients 355
Elfriede R. Greimel and Andrew D. Bottomley
III. Ovarian Cancer
24. Ovarian Cancer 367
Roberto Angioli, Pierluigi Benedetti Panici, Manuel Penalver,
Claes Trope´, and Sergio Pecorelli
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Contents xi
25. Management of Early Epithelial Ovarian Cancer 379
Claes Trope´, Tobjørn Iversen, and Mark Baekelandt
26. Chemotherapy for Advanced Primary Epithelial Ovarian
Cancer: Neoadjuvant and Adjuvant 391
Jan B. Vermorken
27. Persistent and Recurrent Ovarian Cancer 407
Don S. Dizon and David R. Spriggs
28. Intraperitoneal Chemotherapy: Basic Concepts
and Clinical Trials 433
Maurie Markman
29. Chemotherapy for Germ Cell Tumors 441
Christina A. Bandera and Stephen C. Rubin
30. Chemotherapy for Sex Cord–Stromal Tumors 459
Nicoletta Colombo and Gabriella Parma
31. Ovarian Cancer: Rationale and Strategies Beyond
First-Line Treatment 471
Franco M. Muggia and Maitreyee Hazarika
IV. Fallopian Tubes
32. Fallopian Tube Cancer 483
Pierluigi Benedetti Panici, Roberto Angioli, Marco Calcagno,
and Jacobus Pfisterer
33. Chemotherapy of Fallopian Tube Cancer 489
Jacobus Pfisterer and Felix Hilpert
V. Corpus
34. Endometrial Cancer 497
Roberto Angioli, Alessandro Bovicelli, Innocenza Palaia,
and Pierluigi Benedetti Panici
35. Medical Therapy for Endometrial Hyperplasia and Early
Endometrial Cancer in Patients Desiring Future
Childbearing 507
Mario M. Leitao, Jr. and Richard R. Barakat
36. Uterine Carcinomas: Chemotherapy for Primary and
Recurrent Tumors 519
Levi S. Downs, Jr. and Matthew P. Boente
37. Chemotherapy in Uterine Mesenchymal Tumors 529
Nicoletta Donadello, Valentino Bergamini,
and Massimo Franchi
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xii Contents
VI. Cervix
38. Cervical Cancer 547
Pierluigi Benedetti Panici, Roberto Angioli, Manuel Penalver,
and Sergio Pecorelli
39. Neoadjuvant Chemotherapy in Cervical Cancer 555
Pierluigi Benedetti Panici and Roberto Angioli
40. Chemoradiation Therapy for Cervical Cancer 573
Peter Graham Rose
41. Chemotherapy for Recurrent and Advanced Cervical Cancer 589
Isabelle Cadron and Ignace Vergote
VII. Vulva and Vagina
42. Vulvar Cancer 609
Pierluigi Benedetti Panici, Filippo Bellati, and Raimund Winter
43. Chemotherapy in Vulvar Cancer 617
Roberto Angioli, Edgar Petru, and Hellmuth Pickel
44. Vaginal Cancer 625
Roberto Angioli, Innocenza Palaia, and Filippo Bellati
45. Vaginal Cancer Chemotherapy 631
Raimund Winter, Edgar Petru, and Hellmuth Pickel
VIII. Gestational Trophoblastic Disease
46. Management of Hydatidiform Mole 637
John Tidy and B. W. Hancock
47. Trophoblastic Disease 647
Edward Newlands
IX. Rare Tumors
48. Rare Tumor: Melanoma—Lymphoma—Sarcoma 661
Pissamai Yuenyao and John J. Kavanagh
Index 673
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