Most patients with cervical cancer are already at an advanced stage when they are diagnosed. The development of treatment plan is related to the patient’s condition and physical status. Usually, there are radiotherapy, chemotherapy and surgery in the treatment methods.
The commonly used chemotherapy drugs for cervical cancer are
Cisplatin
Indications.
It has good effect on testicular cancer, ovarian cancer, bladder cancer and breast cancer; it has certain effect on cervical cancer, endometrial cancer, kidney cancer, adrenal cancer, prostate cancer head and neck squamous cancer, esophageal cancer, stomach cancer, lung cancer, malignant lymphoma, soft tissue sarcoma, childhood neuroblastoma, osteosarcoma and melanoma.
Usage and dosage.
(1) Intravenous drip: the dosage depends on the effect of chemotherapy and individual response, once (once every 4 weeks), the dosage is 50~100mg/m2; once a week, twice, the dosage is 50mg/m2; once a day, for 5 days, the dosage is 15~20mg/m2. The course of treatment depends on the clinical efficacy, repeat a course every 3~4 weeks. In case of combined use, the dosage should be adjusted appropriately with the course of treatment.
(2) Arterial injection: 80~100mg/m2 once, once a week.
Pharmacology.
This drug is a commonly used metal platinum complex, which is a cell cycle non-specific antitumor drug with a wide anti-tumor spectrum and effective on anaerobic cells.
The central platinum atom in this important molecule is important for its antitumor effect, and only the cis-form is effective, while the trans-form is ineffective.
Carboplatin
Indications.
It is mainly used for ovarian cancer, small cell lung cancer, head and neck cancer, germ cell tumors, but also for thyroid cancer, cervical cancer, bladder cancer and non-small cell lung cancer.
Usage and dosage.
1. Intravenous administration: 300-400mg/m2, intravenous injection or drip, can be increased to 560mg/m2 for children, repeated once in 4 weeks; or 50-70mg/m2 (usually 100mg once), once daily for 5 days, repeated once in 4 weeks. In recent years, it is advocated that the dose should be decided according to the AUC (area under the blood concentration – time curve).
2. Intraperitoneal injection of 300-400mg/m2 once every 4 weeks.
Pharmacology: Causes intra- and inter-strand cross-linking of DNA, resulting in inhibition of DNA synthesis.
Bleomycin
Indications.
(1) Used for malignant skin tumors, head and neck tumors (jaw cancer, tongue cancer, lip cancer, pharyngeal cancer, oral cancer, etc.), lung cancer (especially primary and metastatic phosphorus cancer), esophageal cancer, malignant lymphoma (reticulocytic sarcoma, lymphosarcoma, Hodgkin’s disease), cervical cancer, glioma, thyroid cancer.
(2) It is also used for squamous carcinoma of vagina, vulva, penis and testicular cancer.
Pharmacology: This drug is an antibiotic antitumor agent. The complex with iron is embedded in DNA, causing DNA strand breakage and destroying cancer cells, but not RNA strand breakage.
Usage and dosage.
(1) Intramuscular injection: 15~3Omg once, 2 times a week, can be increased to once a day or reduced to once a week according to the condition.
(2) Subcutaneous injection: see Intramuscular injection for dosage. If the lesion is injected subcutaneously, the concentration should not be higher than 1mg/ml.
(3) Intravenous injection: see Intramuscular Injection for dosage. In case of severe febrile reaction, the dose should be reduced to less than 5mg at a time. The number of doses can also be increased, such as twice a day.
(4) Arterial injection: see Intramuscular injection for dosage. Direct projectile intra-arterial injection or continuous perfusion.
Pharmacokinetics: This drug is not effective when given orally.
The drug cannot be cleared by dialysis.
mitomycin
Indications.
1.Cancer of gastrointestinal tract, such as stomach, intestine, liver, pancreas, etc.
2.Lung cancer, breast cancer, cervical cancer, choriocapillary epithelial cancer.
3.Malignant lymphoma, chronic granulocytic leukemia.
4.Cancerous thoracic and abdominal effusion.
Usage and dosage.
1. 4～6mg per time for adults by sedation, dissolved in 10～20ml of water for injection or saline, 1～2 times per week, 40～60mg for a course of treatment. Also can be used 10-30mg, once every 2-3 weeks.
The drug can also be dissolved in 200ml of 0.9% sodium chloride injection in a static drip (within 1 hour).
2.Arterial injection dose is the same as static injection.
3.Intracavitary injection should be injected 4~10mg as much as possible after the fluid is pumped out, once every 5~7 days, 4~6 times as a course of treatment. It can also be injected into the bladder.
Pharmacology: The anti-cancer mechanism of MMC is mainly alkylation. It depolymerizes DNA in cells, inhibits DNA replication, and also causes single-strand breaks of DNA.
Isocyclophosphamide
Indications.
1.Soft tissue tumor, metastatic bone tumor, testicular tumor.
2.Malignant lymphoma, pancreatic cancer, cervical cancer, ovarian cancer, breast cancer, etc.
3.Lung cancer, etc.
Usage dosage.
Commonly used 5 days course, daily dose 1.2~2.5g/m2, add into 5% glucose sodium chloride injection 250~500ml and input in 30~120 minutes.
Sodium mercaptoethanesulfonate (Mesna) is commonly used as a uroprotective agent, with each dose equal to 20% of the IFO dose, and is infused immediately, 4 hours and 8 hours after the IFO infusion.
The next course is repeated in 3 to 4 weeks. Long-term continuous intravenous infusions or other treatment regimens have also been used.
Pharmacology.
It is an anticancer drug of the nitrogen mustard class, and the duration of maintenance of this product at a given concentration determines its anticancer effect.
Fluorouracil
Indications.
1.Carcinoma of digestive system (stomach, colon, liver, pancreas, esophagus, etc.)
2.Breast cancer, ovarian cancer, cervical cancer, choriocapillary epithelial cancer, malignant staphyloma.
3, bladder cancer, skin cancer, head and neck cancer.
Usage and dosage.
1.Static injection: 500～700mg, once every other day; or 12～15mg/kg a day, change to once every other day after 4～5 days, and reduce the dose by half after toxic reaction; or 500～600mg/m2, once a week. The total amount of a course of treatment can reach 5.0~7.5g.
2.Static drip: generally 15mg/kg, dissolved in saline or 5% glucose injection, dripped for 2-8 hours, once a day for 5 days, and then the dose is halved and once every other day until toxic reaction occurs. For the treatment of chorioepithelial carcinoma, the dose is large, 25-30mg/kg, dissolved in 500-1000ml of 5% glucose injection, drip for 8 hours, every 10 days as a course of treatment, with an interval of 2 weeks. In recent years, continuous intravenous drip dosing is advocated, 300-400mg/m2 for 5 days, 21 days as a cycle, combined with CF can improve the efficacy of colorectal cancer.
3.Intra-arterial drip: 5～20mg/kg (750～1000mg each time), dissolved in 5% glucose injection, drip for 6～8 hours, or the dosage can be divided into 24 hours drip, total 8～10g. for advanced head and neck cancer, the efficiency reaches 53.1%.
4.Orally: 300mg per day, divided into 3 doses, total 10～15g.
5.Local application: 5%-10% ointment for external use, twice daily; intratumoral injection, 250-500mg each time; thoracic injection, 0.75-lg each time, once every 5-7 days; intraperitoneal injection, for those with ascites, 1-2g of 5-FU is injected into the abdominal cavity after the release of ascites; for those without ascites, 1-2g of 5-FU is injected into the abdominal cavity after dilution with 2000ml of physiological saline.
Pharmacology: This product is an anti-pyrimidine antimetabolite with inhibitory effects on tumors in a variety of animals.
Side effects such as nausea, vomiting and bone marrow suppression come with chemotherapy. If side effects occur when receiving chemotherapy, communicate with your doctor and adjust the medication regimen in a timely manner.
If side effects occur during chemotherapy, please communicate with your doctor and adjust your medication regimen.