Kaneyasu Y, Okawa M K, Kokubo N, Takemoto M, Karasawa K, Fukuhara N, Toda J, Okawa T
Dept. of Radiology, Tokyo Women's Medical College.
Gan To Kagaku Ryoho. 1996 Sep;23(11):1486-93.
We analyzed 97 cases of various advanced or recurrent pelvic tumors which were cervix, rectal, ovarian and other tumors treated by intra-arterial infusion chemotherapy (IAIC) with or without radiotherapy. The IAIC regimen was separated into two groups: group I consisting of 5-FU + MMC +/- ADR (54 cases) and group II consisting of CDDP + MMC +/- 5-FU (43 cases) from 1985. The catheter was placed in the bifurcation of abdominal aorta, and from 1990, the catheters were placed in bilateral internal iliac arteries (8 cases). The overall response rate (CR + PR) was 65%, 74% in patients receiving radiotherapy, and 47% in those without radiotherapy. There were no significant differences between each primary site and presence of radiotherapy combination in survival rate. Two-year survival rate and 5-year survival rate was 32% and 15% for all cases, and 65% and 33% for CR cases, respectively. A significantly better survival rate was obtained in patients with CR. Five-year survival rate was 4% in group I, and 35% in group II (p = 0.00216) by chemotherapy regimen. Severe (more than grade III) hematological acute side effects were 45% for all cases. In 8 cases in which the catheters were placed in internal iliac arteries, there were severe skin ulcers in 2 cases, and severe pain of leg or gluteal region requiring narcotics in 3 cases. These data suggest that IAIC mainly with cisplatin with or without radiotherapy is one of the effective treatment for advanced or recurrent pelvic tumors. Also, we should check blood flow distribution periodically, and control the concentration of drugs.
我们分析了97例各种晚期或复发性盆腔肿瘤病例,这些肿瘤包括子宫颈癌、直肠癌、卵巢癌及其他肿瘤,均接受了动脉内灌注化疗(IAIC),部分联合放疗。IAIC方案分为两组:1985年起,I组由5-氟尿嘧啶+丝裂霉素+/-阿霉素组成(54例),II组由顺铂+丝裂霉素+/-5-氟尿嘧啶组成(43例)。导管置于腹主动脉分叉处,1990年起,8例导管置于双侧髂内动脉。总体缓解率(完全缓解+部分缓解)为65%,接受放疗患者为74%,未接受放疗患者为47%。各原发部位及放疗联合情况的生存率无显著差异。所有病例的2年生存率和5年生存率分别为32%和15%,完全缓解病例分别为65%和33%。完全缓解患者的生存率显著更高。化疗方案方面,I组5年生存率为4%,II组为35%(p = 0.00216)。所有病例严重(III级以上)血液学急性副作用发生率为45%。在8例导管置于髂内动脉的病例中,2例出现严重皮肤溃疡,3例出现腿部或臀部剧痛需用麻醉剂。这些数据表明,主要采用顺铂的IAIC联合或不联合放疗是晚期或复发性盆腔肿瘤的有效治疗方法之一。此外,我们应定期检查血流分布,并控制药物浓度。