Tanaka Tomohito, Terai Yoshito, Fujiwara Satoe, Tanaka Yoshimichi, Sasaki Hiroshi, Tsunetoh Satoshi, Yamamoto Kazuhiro, Yamada Takashi, Ohmichi Masahide
Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Japan.
Department of Radiology, Osaka Medical College, Takatsuki, Japan.
Oncotarget. 2018 Dec 28;9(102):37766-37776. doi: 10.18632/oncotarget.26518.
We report a balloon-occluded arterial infusion therapy with an original four-lumen double-balloon catheter (4L-DB) which allows for the efficient injection of an anticancer agent at a high concentration to the target spot for patients with locally advanced uterine cervical cancer.
One hundred and forty-three patients with locally advanced cervical cancer treated with neoadjuvant intra-arterial chemotherapy (NAIAC) or a primary radical hysterectomy (PRH) were retrospectively assessed. The patients in the NAIAC group received irinotecan 70 mg/m2 intravenously on day 1 and 8 and cisplatin 70 mg/m2 intra-arterially using the 4L-DB on day 2 of a 21-day course, and two courses were performed in principle. The radical hysterectomy was performed within 6 weeks after NAIAC.
Ninety-four patients were treated with NAIAC, and 49 patients undertook a PRH. The response rate of NAIAC on MRI was 92.6%. Fourteen patients (14.6%) had no evidence of cancer cells on pathologic diagnoses. The NAIAC group had a longer disease-free survival than the PRH group (p=0.02); however, the overall survival was not significantly different. The relative risk (RR) for recurrence was higher in patients with lymph node metastasis (RR, 4.31; 95% CI, 2.23-8.43) and lower in those who underwent NAIAC (RR, 0.30; 95% CI, 0.14-0.68).
Our results with NAIAC using the 4L-DB catheter in locally advanced cervical cancer indicates beneficial effects on primary lesions and improves disease-free survival.
我们报告一种使用原创的四腔双球囊导管（4L-DB）进行球囊闭塞动脉灌注治疗，该导管可将高浓度抗癌剂有效注入局部晚期子宫颈癌患者的靶点。
回顾性评估143例接受新辅助动脉内化疗（NAIAC）或根治性子宫切除术（PRH）治疗的局部晚期宫颈癌患者。NAIAC组患者在21天疗程的第1天和第8天静脉注射伊立替康70mg/m²，在第2天使用4L-DB动脉内注射顺铂70mg/m²，原则上进行两个疗程。在NAIAC后6周内进行根治性子宫切除术。
94例患者接受NAIAC治疗，49例患者接受PRH。NAIAC在MRI上的缓解率为92.6%。14例患者（14.6%）病理诊断无癌细胞证据。NAIAC组的无病生存期比PRH组长（p=0.02）；然而，总生存期无显著差异。淋巴结转移患者复发的相对风险（RR）较高（RR，4.31；95%CI，2.23-8.43），接受NAIAC的患者相对风险较低（RR，0.30；95%CI，0.14-0.68）。
我们使用4L-DB导管对局部晚期宫颈癌进行NAIAC的结果表明对原发灶有有益作用，并改善了无病生存期。
