Kigawa J, Kanamori Y, Ishihara H, Minagawa Y, Iwamoto K, Terakawa N
Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan.
Am J Clin Oncol. 1992 Dec;15(6):474-9.
Intra-arterial infusion with cisplatin (CDDP) and bleomycin (BLM) was carried out in 21 patients with locally recurrent uterine cervical cancer who were previously treated with irradiation alone. Patients were treated with a bolus infusion into both internal iliac arteries of 50 mg/m2 of CDDP and 30 mg/m2 of BLM. Two to four courses of the infusion therapy were given to each patient, and the response rate, the tumor and serum drug concentrations, and the cell kinetics in tumor tissue were evaluated. The response rate (CR+PR) was 71.4% according to the WHO criteria. There was no difference, in the tumor tissue concentrations of CDDP and BLM between responders and nonresponders. Although the DNA ploidy of tumor cells was not significantly different between the two groups before treatment, both the labeling index with BrdU and the proliferation index with flow cytometry significantly increased 24 hours after treatment in responding tumors but not in nonresponding tumors. These results show that intra-arterial infusion with CDDP and BLM improves the prognosis of recurrent cervical cancer and that labeling and proliferation indices may be useful for determining the response of cervical cancer to intra-arterial chemotherapy.
对21例先前仅接受过放疗的局部复发性子宫颈癌患者进行了顺铂（CDDP）和博来霉素（BLM）动脉内灌注治疗。患者接受双侧髂内动脉大剂量注射，顺铂剂量为50mg/m²，博来霉素剂量为30mg/m²。每位患者接受2至4个疗程的灌注治疗，并评估缓解率、肿瘤和血清药物浓度以及肿瘤组织中的细胞动力学。根据WHO标准，缓解率（CR+PR）为71.4%。缓解者和未缓解者之间，肿瘤组织中顺铂和博来霉素的浓度没有差异。虽然两组治疗前肿瘤细胞的DNA倍体没有显著差异，但治疗后24小时，缓解肿瘤中用BrdU标记的指数和流式细胞术检测的增殖指数均显著增加，而未缓解肿瘤则没有。这些结果表明，顺铂和博来霉素动脉内灌注可改善复发性宫颈癌的预后，标记指数和增殖指数可能有助于确定宫颈癌对动脉内化疗的反应。
