Noguchi M, Murata R, Sagoh T, Yamamoto M, Ueda H, Kinoshita K, Ueta M, Honda H, Miyazaki K, Sasaki T, Tachibana T
Dept. of Radiology, Fukui Red Cross Hospital.
Gan To Kagaku Ryoho. 1998 Jul;25(9):1314-7.
The results of intraarterial chemotherapy (IACT) combined with definitive radiation therapy for 23 advanced and bulky carcinomas of uterine cervix are reported. IA-CT with cisplatin 50 mg and doxorubicin 30 mg was administered by one shot method in bilateral internal iliac arteries. The protocol consisted of one to three treatment session every 3 weeks. Nine of eleven patients with clinical stage III achieved a complete local response (82%), and the 3- and 5-year survival in these cases were 72% and 72%, respectively. These results were superior to the response (58%), 3- and 5-year survivals (68%, 58%) obtained in 19 patients treated mainly with radiation therapy alone. The side effect of grade 2 and 3 for the intestine, such as ileus and hemorrhagic colitis, was noted in 3 patients (15%). In addition, 3 of 8 patients with radical surgery and postoperative radiation therapy after IA-CT developed insufficient fracture of pelvic bone. These complications accompanied by IA-CT combined with radiation therapy and/or surgery increased slightly, compared with that by the previous therapy without IA-CT, but were not critical. The results suggest that IA-CT following radiation therapy is effective to improve the prognosis of patients with Stage III cervical cancer.
本文报告了23例晚期和体积较大的子宫颈癌患者接受动脉内化疗（IACT）联合根治性放射治疗的结果。通过单次注射法，在双侧髂内动脉给予含50mg顺铂和30mg阿霉素的动脉内化疗。治疗方案为每3周进行1至3个疗程。11例临床分期为III期的患者中有9例获得了完全局部缓解（82%），这些患者的3年和5年生存率分别为72%和72%。这些结果优于19例主要接受单纯放射治疗患者的缓解率（58%）、3年和5年生存率（68%、58%）。3例患者（15%）出现了2级和3级肠道副作用，如肠梗阻和出血性结肠炎。此外，8例在动脉内化疗后接受根治性手术和术后放射治疗的患者中有3例发生了骨盆骨骨折不愈合。与未进行动脉内化疗的既往治疗相比，动脉内化疗联合放射治疗和/或手术伴随的这些并发症略有增加，但并不严重。结果表明，放射治疗后进行动脉内化疗可有效改善III期宫颈癌患者的预后。
