Radiotherapy combined with transcatheter arterial infusion of cisplatin versus oral fluoropyrimidine anticancer agent for locally advanced carcinoma of the uterine cervix: A prospective follow-up study

We randomized patients with locally advanced cervical cancer to receive rad iotherapy combined with transcatheter arterial infusion (TAI) of cisplatin or oral fluoropyrimidine anticancer agents, and compared the prognosis by a prospective follow-up study. Sixty patients were studied who completed the ir planned radiation therapy with chemotherapy at the Department of Obstetr ics and Gynecology of Hiroshima University Hospital between January 1991 an d December 1998. Patients were randomly assigned to receive (A) radiotherap y with TAT of 120 mg/body cisplatin twice a month at the interval of 4 week s or (B) radiotherapy with 200 mg/day oral 5-FU or UFT every day. In both g roups, radiotherapy is routinely 50 Gy of external beam irradiation to the whole pelvis and 18-20 Gy (point A dose) of intracavitary irradiation using a remote after loading system (RALS). Serious adverse reactions interferin g with treatment did not appear in either group. The effective histologic r esponse was 28/32 (87.5%) in group A and 25/28 (89.3%) in group B. The medi an follow-up period were 28.3 months and 25.4 months in group A and B, resp ectively. There was no significant difference in the overall survival and d isease-free survival rates for all patients, clinical stage III and squamou s cell carcinoma. We could not conclude that radiotherapy with TAI of cispl atin achieved superior therapeutic efficacy in locally advanced cervical ca ncer. To improve the therapeutic effects, it is important to establish a ne w cisplatin-containing chemoradiotherapy regimen.