[A case of FIGO stage IV A vulvar cancer successfully treated by neoadjuvant chemotherapy with continuous intra-arterial infusion (cisplatin, 5-fluorouracil)].

The subject was a patient who had squamous cell carcinoma in the pudendum and the inguinal region (12.5 x 8.0 cm and 4.5 x 3.0 cm, respectively). A curative operation for FIGO IV A stage (T3N3M0) vulvar cancer is thought to be difficult to perform and is resistant to BOMP therapy, so continuous arterial infusion therapy consisting of cisplatin (CDDP, 10 mg/day, day 2-4, one shot) and 5-fluorouracil (5-FU, 250 mg/day, day 1-4, continuous) was performed weekly via bilateral femoral arteries to the lower end of the branches of bilateral superior gluteal arteries. In consequence, the tumor started to clearly shrink from the first week. After treatment with total doses of 210 mg of CDDP and 7,000 mg of 5-FU, the patient underwent complete resection of the tumor without skin grafting, and a histological efficacy of Grade 1-b or above was obtained. No adverse reactions were found, and the free Pt AUC in the peripheral blood was 0.85 mg.hr/l per course. Pt concentration in the pudendum 2 hours after CDDP therapy was 2.9 micrograms/g. Because of little adverse reaction and high efficacy, this method appeared to be a therapeutic method worth considering from the viewpoint of the quality of life of patients with the progressive vulvar cancer prevalent in elderly persons.