Kigawa J, Minagawa Y, Ishihara H, Itamochi H, Kanamori Y, Terakawa N
Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan.
Am J Clin Oncol. 1996 Jun;19(3):255-9. doi: 10.1097/00000421-199606000-00009.
To clarify the effect of neoadjuvant intraarterial infusion chemotherapy on the cure rate in advanced cervical cancer with bulky tumor, a total of 50 patients were examined prospectively. The clinical stage according to the International Federation of Gynecology and Obstetrics (FIGO) classification included 23 IIb, 6 IIIa, and 21 IIIb. These patients were randomly divided into the neoadjuvant intraarterial infusion chemotherapy group and the control group. There were no significant differences in mean age, FIGO clinical stage, and tumor histology between groups. Twenty-five patients in the former group were given 25 mg/m2 of cisplatin and 15 mg/m2 of bleomycin via each internal iliac artery. If the results of the evaluation indicated that surgery was feasible, radical surgery was performed. The patients whose tumors were inoperable received radiation therapy consisting of external irradiation and intracavitary irradiation. Twenty-five patients in the control group also underwent the same radiation therapy. The overall response rate was 80.0%. Eighteen of 20 responders underwent surgery. The 3-year survival rate was 85.7% for operated patients, 42.9% for patients receiving neoadjuvant intraarterial infusion chemotherapy followed by irradiation, and 49.5% for the control group. In the present study, neoadjuvant intraarterial infusion chemotherapy did not improve the prognosis of patients with advanced cervical cancer compared to radiation therapy alone, and only responders who underwent surgery obtained an advantage in survival.
为阐明新辅助动脉内灌注化疗对伴有巨大肿瘤的晚期宫颈癌治愈率的影响，前瞻性地检查了总共50例患者。根据国际妇产科联盟（FIGO）分类的临床分期包括23例IIb期、6例IIIa期和21例IIIb期。这些患者被随机分为新辅助动脉内灌注化疗组和对照组。两组之间的平均年龄、FIGO临床分期和肿瘤组织学无显著差异。前一组的25例患者通过每条髂内动脉给予25mg/m²顺铂和15mg/m²博来霉素。如果评估结果表明手术可行，则进行根治性手术。肿瘤无法手术切除的患者接受由外照射和腔内照射组成的放射治疗。对照组的25例患者也接受相同的放射治疗。总缓解率为80.0%。20例缓解者中有18例接受了手术。手术患者的3年生存率为85.7%，接受新辅助动脉内灌注化疗后放疗的患者为42.9%，对照组为49.5%。在本研究中，与单纯放疗相比，新辅助动脉内灌注化疗并未改善晚期宫颈癌患者的预后，只有接受手术的缓解者在生存方面获得优势。
