EXTENDED INTRAARTERIAL CISPLATIN INFUSION FOR TREATMENT OF GYNECOLOGIC CANCER AFTER ALTERATION OF INTRAPELVIC BLOOD-FLOW AND IMPLANTATION OF A VASCULAR ACCESS DEVICE

Purpose: Twenty-two patients with advanced gynecologic cancer underwen t extended intraarterial cisplatin infusion after alteration of the in trapelvic blood flow and implantation of a vascular access device (VAD ). Methods: To maximize concentrations of cisplatin at the target lesi on, the superior and inferior gluteal arteries were embolized with ste el coils. The tip of the catheter was inserted into the internal iliac artery; the opposite end of the catheter was connected to the VAD. Re sults: Intensive radioisotope accumulation was demonstrated in the ant erior division of the pelvis, seen by scintigraphy performed with tech netium 99m macroaggregated albumin via the VAD. Local perfusion in the tumor was well seen by ultrasonographic angiography with CO2 microbub bles via the VAD. Continuous consecutive infusion of cisplatin at a ra te of 12.5 mg/day via the VAD minimized the toxicity. The overall resp onse rate was 73%. Radical surgery was possible in 16 of the 22 patien ts after this intraarterial infusion. Conclusion: This method was usef ul for treating advanced gynecologic cancer without significant toxici ty.