Effect of epirubicin combined with docetaxel on inflammatory factors, cytokines, tumor markers, clinical efficacy and adverse reactions in patients with cervical cancer after surgery

To investigate the clinical efficacy of epirubicin combined with docetaxel in postoperative patients with cervical cancer. A total of 124 postoperative cervical cancer patients were randomly allocated into two groups: the control group (n = 62) and the experimental group (n = 62), using a random number table. Patients in both groups underwent extensive hysterectomy, pelvic nerve-sparing lymphadenectomy, and other surgical interventions as deemed necessary. Postoperatively, the control group received intravenous epirubicin, while the experimental group received intravenous docetaxel in addition to epirubicin. After 3 courses of treatment, the serum levels of interleukin-2 (IL-2), IL-6, IL-4 and interferon γ (IFN-γ) in the experimental group were lower than that in the control group. The levels of IL-2/IL-6, IFN-γ/IL-4, IL-2/IL-4 and IFN-γ/IL-6 were lower than that in the control group. The serum levels of carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1) and squamous cell carcinoma antigen (SCC-Ag) were lower than that in the control group. The disease control rate was 74.19% (46/62), higher than 56.45% (35/62) in the control group. The incidence of adverse reactions was 6.45% (4/62), lower than 19.35% (12/62) in the control group. The combination of epirubicin and docetaxel demonstrates efficacy in the treatment of postoperative cervical cancer.

Epirubicin; Docetaxel; Postoperative cervical cancer; Clinical efficacy

[1] Sun K, Huang C, Li JZ, Luo ZX. Identification of a necroptosis-related prognostic gene signature associated with tumor immune microenvironment in cervical carcinoma and experimental verification. World Journal of Surgical Oncology. 2022; 20: 342.

[2] Sheng J, Xiang Y, Shang L, He Q. Molecular alterations and clinical relevance in cervical carcinoma and precursors (Review). Oncology Reports. 2020; 44: 2397–2405.

[3] Diefenbach D, Greten HJ, Efferth T. Genomic landscape analyses in cervical carcinoma and consequences for treatment. Current Opinion in Pharmacology. 2020; 54: 142–157.

[4] Song X, Li R, Wang H, Song P, Guo W, Chen ZS. Tisotumab vedotin for the treatment of cervical carcinoma. Drugs Today. 2022; 58: 213–222.

[5] Zhang J, Chen X, Shu L, Liu C. The correlation and role analysis of SLC30A1 and SLC30A10 in cervical carcinoma. Journal of Cancer. 2022; 13: 1031–1047.

[6] Franco I, Viswanathan AN. Radiation oncology management of stage III and IVA cervical carcinoma. International Journal of Gynecologic Cancer. 2022; 32: 231–238.

[7] Kampers J, Gerhardt E, Sibbertsen P, Flock T, Klapdor R, Hertel H, et al. Protective operative techniques in radical hysterectomy in early cervical carcinoma and their influence on disease-free and overall survival: a systematic review and meta-analysis of risk groups. Archives of Gynecology and Obstetrics. 2021; 304: 577–587.

[8] Kilic C, Yuksel D, Cakir C, Karalok A, Boyraz G, Moraloglu Tekin O, et al. Pulmonary recurrence after radical hysterectomy for uterine cervical carcinoma. Journal of Obstetrics and Gynaecology. 2020; 40: 1155–1159.

[9] Matsuo K, Tavakoli A, Donovan KM, Mandelbaum RS, Klar M, Roman LD, et al. Utilization of lymph node evaluation at hysterectomy for cervical carcinoma in situ. Journal of Surgical Oncology. 2022; 126: 1543–1550.

[10] Guigay J, Aupérin A, Fayette J, Saada-Bouzid E, Lafond C, Taberna M, et al. Cetuximab, docetaxel, and cisplatin versus platinum, fluorouracil, and cetuximab as first-line treatment in patients with recurrent or metastatic head and neck squamous-cell carcinoma (GORTEC 2014-01 TPExtreme): a multicentre, open-label, randomised, phase 2 trial. The Lancet Oncology. 2021; 22: 463–475.

[11] Hsieh C, Lin C, Huang Y, Chen J, Tsou Y, Chang L, et al. Macrophage secretory IL-1β promotes docetaxel resistance in head and neck squamous carcinoma via SOD2/CAT-ICAM1 signaling. JCI Insight. 2022; 7: e157285.

[12] Li Z, Li C, Wu Q, Tu Y, Wang C, Yu X, et al. MEDAG enhances breast cancer progression and reduces epirubicin sensitivity through the AKT/AMPK/mTOR pathway. Cell Death & Disease. 2021; 12: 97.

[13] Zhang J, Jiang H, Zhang J, Bao G, Zhang G, Wang H, et al. Effectiveness and safety of pegylated liposomal doxorubicin versus epirubicin as neoadjuvant or adjuvant chemotherapy for breast cancer: a real-world study. BMC Cancer. 2021; 21: 1301.

[14] Chu D, Liu T, Yao Y. Implications of viral infections and oncogenesis in uterine cervical carcinoma etiology and pathogenesis. Frontiers in Microbiology. 2023; 14: 1194431.

[15] Li C, Li X, Zhang Y, Wu L, He J, Jiang N, et al. DSCAM-AS1 promotes cervical carcinoma cell proliferation and invasion via sponging miR-338-3p. Environmental Science and Pollution Research. 2022; 29: 58906–58914.

[16] Matsuo K, Violette CJ, Mandelbaum RS, Shoupe D, Roman LD. Utilizations and characteristics of ovarian conservation at hysterectomy for cervical carcinoma in situ. International Journal of Gynecology & Obstetrics. 2023; 161: 631–639.

[17] Kampers J, Gerhardt E, Sibbertsen P, Flock T, Hertel H, Klapdor R, et al. Perioperative morbidity of different operative approaches in early cervical carcinoma: a systematic review and meta-analysis comparing minimally invasive versus open radical hysterectomy. Archives of Gynecology and Obstetrics. 2022; 306: 295–314.

[18] Zhang L, Wu ZY, Li J, Lin Y, Liu Z, Cao Y, et al. Neoadjuvant docetaxel plus carboplatin vs epirubicin plus cyclophosphamide followed by docetaxel in triple-negative, early-stage breast cancer (NeoCART): results from a multicenter, randomized controlled, open-label phase II trial. International Journal of Cancer. 2022; 150: 654–662.

[19] Patil VM, Noronha V, Menon N, Singh A, Ghosh-Laskar S, Budrukkar A, et al. Results of phase III randomized trial for use of docetaxel as a radiosensitizer in patients with head and neck cancer, unsuitable for cisplatin-based chemoradiation. Journal of Clinical Oncology. 2023; 41: 2350–2361.

[20] Heianna J, Makino W, Hirakawa H, Yamashita Y, Tomita H, Murayama S. Therapeutic efficacy of intra-arterial docetaxel and nedaplatin infusion concomitant with radiotherapy for T4 maxillary sinus squamous cell carcinoma. International Journal of Oral and Maxillofacial Surgery. 2022; 51: 1123–1130.

[21] Qin H, Lu Y, Du L, Shi J, Yin H, Jiang B, et al. Pan-cancer analysis identifies LMNB1 as a target to redress Th1/Th2 imbalance and enhance PARP inhibitor response in human cancers. Cancer Cell International. 2022; 22: 101.

[22] Liu W, Li M, Zhang X, Zhou Z, Shen Z, Shen X. Association of polymorphisms in Th1/Th2-related cytokines (IFN-γ, TGFβ1, IL-1β, IL-2, IL-4, IL-18) with oral lichen planus: a pooled analysis of case-control studies. Journal of Dental Sciences. 2023; 18: 560–566.

[23] Guo S, Qin F, Wang J, Ding Y, You J, Chao C. Correlation of serum IL-2 and IFN-γ levels with clinical prognosis of nasopharyngeal carcinoma patients and analysis of risk factors. Journal of Medical Biochemistry. 2024; 43: 50–56.

[24] Lin W, Zhang HL, Niu ZY, Wang Z, Kong Y, Yang XS, et al. The disease stage-associated imbalance of Th1/Th2 and Th17/Treg in uterine cervical cancer patients and their recovery with the reduction of tumor burden. BMC women’s Health. 2020; 20: 126.

[25] Guo Q, Chen W, Sun J, Zhao C, Bai X, Zhang Y, et al. Nocardia rubra cell-wall skeleton activates an immune response in cervical tissue via stimulating FPR3 to enhance dendritic cell-mediated Th1 differentiation. Frontiers in Immunology. 2023; 14: 1117545.

[26] Zhang Z, Li Y, Wu Y, Bi R, Wu X, Ke G, et al. Identifying tumor markers-stratified subtypes (CA-125/CA19-9/carcinoembryonic antigen) in cervical adenocarcinoma. The International Journal of Biological Markers. 2023; 38: 223–232.

[27] Ran C, Sun J, Qu Y, Long N. Clinical value of MRI, serum SCCA, and CA125 levels in the diagnosis of lymph node metastasis and para-uterine infiltration in cervical cancer. World Journal of Surgical Oncology. 2021; 19: 343.

[28] Huang G, Chen R, Lu N, Chen Q, Lv W, Li B. Combined evaluation of preoperative serum CEA and CA125 as an independent prognostic biomarker in patients with early-stage cervical adenocarcinoma. OncoTargets and Therapy. 2020; 13: 5155–5164.

[29] Zhang Q, Wang Z, Tang H, Zhang B, Yue C, Gao J, et al. Serum CYFRA21-1 and SCC-Ag levels in women during pregnancy and their diagnostic value for cervical cancer. Cancer Treatment and Research Communications. 2024; 38: 100786.

[30] Zhang J, Dong D, Wei Q, Ren L. CXCL10 serves as a potential serum biomarker complementing SCC-Ag for diagnosing cervical squamous cell carcinoma. BMC cancer. 2022; 22: 1052.