title: Anal submucosal injection: a new route for drug administration in pelvic malignancies. IV. Submucosal anal injection in the treatment of cancer of uterine cervix--preliminary study.
abstract: Seven patients with advanced cancer of the uterine cervix were treated by anal submucosal injection of methotrexate. Each course consists of five injections, one every 5 days; each injection contains 100 mg of methotrexate. The course was repeated at 3-week intervals and was given on an outpatient basis. Investigations were performed before, during, and after treatment. Methotrexate blood level was measured 4 and 24 hours after administration. Complete response occurred in all seven patients. Relapse occurred in four but could be controlled by further methotrexate administration. Average duration of survival is 46 1/2 months. No side effects were encountered as a result of a low methotrexate serum level that was recorded 4 hours after administration, 0.82 mumol after anal injection compared with 2.8 mumol for the intravenous route. The beneficial effect seems to be the result of the high methotrexate concentration in uterine and tumor tissue. The route adopted by the drug to reach the uterus from the anal submucosa is through the hemorrhoidogenital communicating veins. This preliminary study demonstrates that anal injection of methotrexate is effective in the treatment of advanced cancer. It is safe, well tolerated, and can be used as an outpatient treatment.
authors.affiliation: Department of Surgery, Faculty of Medicine, Cairo University, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Shafik
mesh_terms: D000368:Aged; D001003:Anal Canal; D005260:Female; D006801:Humans; D007267:Injections; D007413:Intestinal Mucosa; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000188:drug therapy*; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy*
chemical_list: D008727:Methotrexate