Intraarterial Chemotherapy Followed by Radical Hysterectomy for Locally Advanced Cervical Cancer / 复旦学报（医学版）

ABSTRACT

PurposeTo evaluate the curative effect and possibility of the intraarterial chemotherapy followed by radical hysterectomy for locally advanced cervical cancer. Methods59 patients with FIGO stage lb-IV cervical cancer were enrolled and the tumor size with stage lb and Ua must be more than 4 cm. Treatment consisted of bilateral internal iliac artery infusion of cisplatin 80 rog, 5-Fu 1 500 rog, and AT1258 60 mg for 1 - 3 courses separated by 3 weeks. The tumor size was measured by vagina ultrasonic and CT before and after chemotherapy to calculate the shrunk size percent. All patients underwent radical hysterectomy. Patients with disease in the vagina, parametrium, pelvic lymphnodes or microscopic tumor emboli were followed postoperative pelvic irradiation. Results59 patients underwent 122 courses of intraarterial chemotherapy for 1 - 3 courses each. The total response rate was 95 %. Complete response (CR) was achieved in 18 of 59 patients (31%) ,while a partial response (PR) was noted in 38 (64%) and stable disease (SD) in 3 (5% ). No patient had progressive disease. 14 patients with pelvic lymphnode metastasis were all found to have PR and SD. No patient had lymphnode metastasis in CR. Of 18 patients with CR, 17 patients had not recurrence. Only one patient with stage lla recurred 20 months after operation. But he also cured. All 18 patients with CR were living free of disease. But 3 in 38 patients with PR died and 3 patients with SD were all died. There were no severe complications related to intraarterial chemotherapy and radical hysterectomy. Conclusionslntraarterial chemotherapy before operation can shrink tumor size, decrease the lymphnode metastasis. It is feasible in helping elevating cure rate of patients with locally advanced cervical cancer who are at high risk for failure with conventional treatment.