Chemotherapy of cervical carcinoma: use of Tc-99m-MAA infusion to predict drug distribution.

Nineteen patients with cervical cancer had infusion of Tc-99m-macroaggregated albumin particles (MAA) via bilateral internal iliac artery catheters to aid in dividing chemotherapeutic dose appropriately between the two catheters. Unequal drug distribution was used to minimize extrapelvic complications (local gluteal burns) by reducing the dose to the side with the greatest gluteal perfusion, or to increase the dose to the tumor regions that showed heightened perfusion. Pulmonary uptake, due primarily to arteriovenous shunting in the tumor bed, was seen in all patients. The authors suggest that bulk reduction of locally advanced cervical carcinoma in patients without prior irradiation may be achieved by intra-arterial chemotherapy with tolerable toxicity.