Scarabelli C, Tumolo S, De Paoli A, Frustaci S, Campagnutta E, Morassut S, Franchin G, Crivellari D, Sopracordevole F, Lo Re G
Cancer. 1987 Jul 1;60(1):25-30. doi: 10.1002/1097-0142(19870701)60:1<25::aid-cncr2820600106>3.0.co;2-5.
The preliminary results of intraarterial chemotherapy with peptichemio, doxorubicin, and cisplatin as part of a multimodality treatment in locally advanced and recurrent cervical carcinomas are reported. Treatment consisted of a bilateral sequential infusion of peptichemio 20 mg, doxorubicin 10 mg and cisplatin 20 mg in a 6-hour period via an external infusion pump. After a rest period of 4 days, treatment restarted until maximum response or toxicity. Twenty-five patients, 12 with primary advanced (four Stage IIb, eight Stage III) and 13 with recurrent tumors were treated. All previously untreated patients obtained objective response. In particular, two patients with Stage IIb and III disease, respectively, achieved a complete response. Nine of 13 patients with recurrent disease (69%) were responsive, too, and therefore an overall objective response rate of 84% was achieved. Responses were noted after a median of five cycles of chemotherapy, whereas hematologic toxicity observed in all but one patient, was encountered after a median of four cycles. Toxicity of grade 1 and 2 was noted in 19 patients (76%), whereas of grade 3 and 4 in only 5 (20%). One treatment-related death, due to sepsis during myelosuppression, was reported. Catheter-related toxicity was noted in four patients causing femoral thrombosis in two. In one case a bypass operation was required. After intraarterial chemotherapy, all 21 responsive patients were eligible for radical surgery and 18 (86%) underwent both surgery and postoperative radiation therapy. Surgery was excluded in three patients. In these three cases radiation therapy alone was employed. In this series, the schedule of intraarterial chemotherapy employed was very effective. Patient accrual is ongoing in order to confirm the response rate so far obtained and to evaluate, with a longer follow-up, the impact of this multidisciplinary approach on local control and survival.
报告了采用派来霉素、阿霉素和顺铂进行动脉内化疗作为局部晚期和复发性宫颈癌多模式治疗一部分的初步结果。治疗方法是通过外部输液泵在6小时内双侧序贯输注派来霉素20毫克、阿霉素10毫克和顺铂20毫克。休息4天后重新开始治疗，直至达到最大反应或出现毒性。共治疗了25例患者，其中12例为原发性晚期患者（4例IIb期，8例III期），13例为复发性肿瘤患者。所有先前未接受过治疗的患者均获得了客观反应。特别是，分别有2例IIb期和III期疾病患者实现了完全缓解。13例复发性疾病患者中有9例（69%）有反应，因此总体客观反应率达到84%。化疗中位数为5个周期后出现反应，而除1例患者外所有患者均在化疗中位数为4个周期后出现血液学毒性。19例患者（76%）出现1级和2级毒性，而只有5例（20%）出现3级和4级毒性。报告了1例与治疗相关的死亡，原因是骨髓抑制期间发生败血症。4例患者出现与导管相关的毒性，其中2例导致股静脉血栓形成。1例患者需要进行搭桥手术。动脉内化疗后，所有21例有反应的患者均符合根治性手术条件，18例（86%）接受了手术及术后放疗。3例患者被排除在手术之外。在这3例患者中仅采用了放疗。在本系列研究中，所采用的动脉内化疗方案非常有效。目前正在继续招募患者，以确认目前获得的反应率，并通过更长时间的随访评估这种多学科方法对局部控制和生存的影响。
