Sueyama H, Nakano M, Sakumoto K, Toita T, Takizawa Y, Moromizato H, Kakihana Y, Kushi A, Moromizato H, Higashi M
Department of Radiology, Niigata University School of Medicine, Japan.
Gynecol Oncol. 1995 Dec;59(3):327-32. doi: 10.1006/gyno.1995.9968.
Locally advanced cervical cancer has a dismal prognosis, with a high local failure rate and a poor survival rate. To improve the cure rate for advanced carcinoma of the cervix, we initiated a study of intra-arterial (I-A) chemotherapy with cisplatin via the uterine artery prior to definitive radiotherapy. I-A chemotherapy via the internal iliac artery has been used to treat advanced cervical cancer; however, access by way of the uterine artery has not been tested for this purpose. Thirty-four patients with central tumor > or = 5 cm in anteroposterior diameter observed on CT scans were treated with I-A chemotherapy. I-A chemotherapy consisted of unilateral catheterization of the uterine artery using 120 mg/m2 cisplatin. After assessment of I-A chemotherapy, all but 3 patients were treated with a combination of whole-pelvis external irradiation and intracavitary irradiation. The 3 patients underwent external radiotherapy alone. Twenty-seven of 34 patients treated were evaluable for response to I-A chemotherapy. Eleven patients (41%) experienced a partial response. Seventy-six percent of the 34 patients treated with I-A chemotherapy followed by radiotherapy exhibited a complete response by the end of treatment. Toxicity was well tolerated and no death due to treatment occurred. The 2- and 5-year actuarial survival rates were 64 and 55%, respectively. The crude incidences of pelvic recurrence and distant metastasis observed at a median follow-up of 54 months were both 47%. This study for locally advanced cervical cancer suggests there is benefit to be derived from our I-A chemotherapy followed by radical radiotherapy.
局部晚期宫颈癌预后不佳，局部复发率高，生存率低。为提高晚期宫颈癌的治愈率，我们开展了一项研究，在根治性放疗前经子宫动脉进行顺铂动脉内化疗。经髂内动脉进行动脉内化疗已用于治疗晚期宫颈癌；然而，尚未针对此目的测试经子宫动脉的途径。对34例CT扫描显示中央肿瘤前后径≥5 cm的患者进行了动脉内化疗。动脉内化疗包括使用120 mg/m²顺铂对子宫动脉进行单侧插管。在评估动脉内化疗后，除3例患者外，所有患者均接受了全盆腔外照射和腔内照射联合治疗。这3例患者仅接受了外照射放疗。34例接受治疗的患者中有27例可评估对动脉内化疗的反应。11例患者（41%）出现部分缓解。34例接受动脉内化疗后放疗的患者中有76%在治疗结束时出现完全缓解。毒性耐受性良好，未发生因治疗导致的死亡。2年和5年精算生存率分别为64%和55%。在中位随访54个月时观察到的盆腔复发和远处转移的粗发病率均为47%。这项针对局部晚期宫颈癌的研究表明，我们的动脉内化疗后行根治性放疗有获益。
