Recurrent cervical cancer in the pelvis--intra-arterial infusion of oncostatics.
Five cases of recurrent cervical carcinoma with sites of recurrence restricted to the pelvis were treated by intra-arterial infusion of oncostatics via the bilateral internal iliac arteries. One tip of the catheter was positioned in the internal iliac artery, proximal and close to the superior glutea artery, through the arteria glutea superior or inferior with ligations of both arteria glutea superior and inferior so as to give high concentration of drugs in the lesion. The other tip of the catheter was introduced subcutaneously up to the subclavian fossa of the anterior chest and was secured to the skin. Several chemotherapeutic agents (cisplatin, adriamycin, pepleomycin, mitomycin C and 5-fluorouracil) were infused repeatedly through the catheter, once or twice a week. The clinical efficacy according to Karnovsky's criteria was 0-C in one case, 1-A in one case and 1-B in three cases. The overall response rate of 1-B or higher was 60%. Two patients died, one from inflammation in the pelvic dead space and disseminated intravascular coagulopathy, the other from myocarditis and heart failure. The other three are alive and being treated by weekly intra-arterial infusion of chemotherapeutic agents at our outpatient clinic. No problems, such as spontaneous removal of the catheter, inflammation around the catheter or bleeding, have been encountered. The toxicity of the oncostatics in case of intra-arterial infusion was less pronounced than in the case of intra-venous administration of the same dose.(ABSTRACT TRUNCATED AT 250 WORDS)
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002404:Catheterization; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007044:Hysterectomy; D007083:Iliac Artery; D007261:Infusions, Intra-Arterial; D008207:Lymphatic Metastasis; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D010386:Pelvic Neoplasms / Q000188:drug therapy / Q000556:secondary*; D017663:Peplomycin; D012008:Recurrence; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy
D008937:Mitomycins; D001761:Bleomycin; D016685:Mitomycin; D017663:Peplomycin; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil