THE ROLE OF NEOADJUVANT INTRAARTERIAL INFUSION CHEMOTHERAPY WITH CISPLATIN AND BLEOMYCIN FOR LOCALLY ADVANCED CERVICAL-CANCER

To clarify the effect of neoadjuvant intraarterial infusion chemothera py on the cure rate in advanced cervical cancer with bulky tumor, a to tal of 50 patients were examined prospectively. The clinical stage acc ording to the International Federation of Gynecology and Obstetrics (F IGO) classification included 23 IIb, 6 IIIa, and 21 IIIb. These patien ts were randomly divided into the neoadjuvant intraarterial infusion c hemotherapy group and the control group. There were no significant dif ferences in mean age, FIGO clinical stage, and tumor histology between groups. Twenty-five patients in the former group were given 25 mg/m(2 ) of cisplatin and 15 mg/m(2) of bleomycin via each internal iliac art ery. If the results of the evaluation indicated that surgery was feasi ble, radical surgery was performed. The patients whose tumors were ino perable received radiation therapy consisting of external irradiation and intracavitary irradiation. Twenty-five patients in the control gro up also underwent the same radiation therapy. The overall response rat e was 80.0%. Eighteen of 20 responders underwent surgery. The 3-year s urvival rate was 85.7% for operated patients, 42.9% for patients recei ving neoadjuvant intraarterial infusion chemotherapy followed by irrad iation, and 49.5% for the control group. In the present study, neoadju vant intraarterial infusion chemotherapy did not improve the prognosis of patients with advanced cervical cancer compared to radiation thera py alone, and only responders who underwent surgery obtained an advant age in survival.