Published in:
01-06-2003 | Clinical Investigations
Neoadjuvant Intra-Arterial Chemotherapy for Locally Advanced
Uterine Cervical Cancer: Clinical Efficacy and Factors Influencing
Response
Authors:
Katsuhiro Kobayashi, Akira Furukawa, Masashi Takahashi, Kiyoshi Murata
Published in:
CardioVascular and Interventional Radiology
|
Issue 3/2003
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Abstract
Purpose: To evaluate the effects of
neoadjuvant intra-arterial chemotherapy (NAIC) for locally advanced
uterine cervical cancer, and to analyze factors influencing the
response to the chemotherapy.
Methods: Thirty-four
patients with invasive cervical cancer more than 4 cm in diameter were
enrolled in this study. NAIC was performed using cisplatin-based
regimens. The response was assessed by magnetic resonance imaging (MRI)
and examination of surgical specimens. Pretreatment factors involved in
the response to NAIC were evaluated and the relationship between the
factors and the prognosis was assessed.
Results:
Clinical response was achieved in 28 (82%) patients. Thirty-one of 49
invasions in the parametrial halves disappeared. Seventeen of 28 lymph
node swellings responded to NAIC. Six of the 14 stage III patients
became operable. In the 19 surgical cases, pathologically complete
responses were found in four. Twenty-eight of the 38 parametrial halves
were free from cancer. No lymph node metastases were found in eight
patients. Initial tumor volume was found to be an independent,
significant determining factor of the response to NAIC. Patients with
initial tumor volumes less than 80 cm3 had a significantly
better estimated 5-year disease-free survival rate compared with those
with larger tumors.
Conclusion: NAIC for locally
advanced cervical cancer is useful for preoperative tumor reduction.
Tumor volume is a significant determining factor for the response to
NAIC.