title: Extended intraarterial cisplatin infusion for treatment of gynecologic cancer after alteration of intrapelvic blood flow and implantation of a vascular access device.
abstract: OBJECTIVE
  Twenty-two patients with advanced gynecologic cancer underwent extended intraarterial cisplatin infusion after alteration of the intrapelvic blood flow and implantation of a vascular access device (VAD).
  
  
  METHODS
  To maximize concentrations of cisplatin at the target lesion, the superior and inferior gluteal arteries were embolized with steel coils. The tip of the catheter was inserted into the internal iliac artery; the opposite end of the catheter was connected to the VAD.
  
  
  RESULTS
  Intensive radioisotope accumulation was demonstrated in the anterior division of the pelvis, seen by scintigraphy performed with technetium 99m macroaggregated albumin via the VAD. Local perfusion in the tumor was well seen by ultrasonographic angiography with CO2 microbubbles via the VAD. Continuous consecutive infusion of cisplatin at a rate of 12.5 mg/day via the VAD minimized the toxicity. The overall response rate was 73%. Radical surgery was possible in 16 of the 22 patients after this intraarterial infusion.
  
  
  CONCLUSIONS
  This method was useful for treating advanced gynecologic cancer without significant toxicity.
authors.affiliation: Department of Radiology, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105 Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: F
authors.initials: F
authors.lastname: Ohsugi
authors.forename: T
authors.initials: T
authors.lastname: Irie
authors.forename: C
authors.initials: C
authors.lastname: Ishii
authors.forename: S
authors.initials: S
authors.lastname: Sadaoka
authors.forename: S
authors.initials: S
authors.lastname: Tada
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000188:drug therapy*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007083:Iliac Artery; D007261:Infusions, Intra-Arterial / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply; D012039:Regional Blood Flow; D013668:Technetium Tc 99m Aggregated Albumin; D014463:Ultrasonography / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D013668:Technetium Tc 99m Aggregated Albumin; D002945:Cisplatin