Neoadjuvant chemotherapy by transcatheter arterial infusion method for uterine cervical cancer

PURPOSE: The effects of transcatheter intraarterial infusion of anticancer drugs on the prognosis of cervical cancer were retrospectively studied. MATERIALS AID METHODS: Two or three sessions of transcatheter arterial infu sion therapy were performed in 97 patients with primary uterine cervical ca ncer. The number of patients in stage I, II, III, or TV were 15, 37, 34, an d 11, respectively. The drugs infused were cisplatin (60-70 mg/m(2)), doxor ubicin hydrochloride (30-40 mg/m2), mitomycin (15 mg/m2), and 5-fluorouraci l (500 mg/body). They were infused via the bilateral internal iliac arterie s. Seventy-five patients of the 97 (78%) underwent radical hysterectomy aft er arterial infusion: stage I (14 of 15), stage II (31 of 37), stage III (2 5 of 34), and stage IV (5 of 11). Three stage II and nine stage III patient s received radical radiation therapy. The other 10 patients tone with stage I, three with stage II, and six with stage IV did not receive an operation and radiation therapy after arterial infusion because of their distant met astases at the time of operation. Thirty-eight patients of 75 (51%) receive d postoperative radiation therapy. RESULTS: The complete histologic response rates (no active cancer cells) af ter arterial infusion were four of 14, four of 31, six of 25, and one of fi ve for stages I, II, III, and IV. The histologic response rates, which show ed no parametrial invasion after arterial infusion, were 12 of 14, 24 of 31 , and 15 of 25 for stages I, II, and III. The histologic response rates, wh ich demonstrated no lymph node metastases after arterial infusion, were 12 of 14, 24 of 31, and 19 of 25 for stages I, II, and III. The overall 5-year survival rates of the patients with stages I, II, and III were 93.3%, 58.7 %, and 69.7%, respectively. The B-year survival rates of the operated patie nts with stages I, II, and III were 100%, 60.5%, and 63.6%, respectively. T he 5-year survival rates of the irradiated patients with stage III was 87.5 %. Leukocytopenia and thrombocytopenia occurred as an acute complication in 75% and 79% of the patients, respectively. As a late complication, ileus o ccurred in 7%. CONCLUSION: Arterial infusion may improve the prognosis of patients with ce rvical cancer without increasing the incidence of late complications.