Preliminary experience with locoregional intraarterial chemotherapy of uterine cervical or endometrial cancer using the peripheral implantable port system (PIPS): a feasibility study.
The purpose of this study was to assess the suitability of a percutaneously implantable catheter port system (PIPS) for repeated intraarterial locoregional chemotherapy (ILC) for cervical and endometrial carcinoma. In 30 patients with advanced, recurrent, or high-risk cervical (n = 23) or endometrial (n = 7) carcinoma, PIPS for ILC was implanted via a femoral access, the catheter localized in the infrarenal abdominal aorta. Chemotherapy was performed adjuvantly after surgery (n = 14) or neo-adjuvantly to enable surgery, or for palliation (n = 16). Port implantation, catheter placement, and repeated port puncture was uneventful in all patients. Complications included catheter dislocation (n = 1), catheter thrombosis (n = 2), subcutaneous infection (n = 1), port-bed skin atrophy (n = 1), requiring port explantation in 3 patients. At 2 years follow-up, complete remission was observed in 7/14 patients with adjuvant chemotherapy, partial remission in 3/14. Successful down-staging could be achieved in 4/8 patients with neo-adjuvant chemotherapy. The PIPS is suitable for repeated ILC which may be a valuable method for pre- and post-surgical therapy of advanced or high-risk cervical and endometrial cancer, for adjuvant chemotherapy as well as neo-adjuvantly for down-staging, or for palliation.
Strecker
Ernst-Peter
EP
Department of Diagnostic Imaging, Diakonissenkrankenhaus Karlsruhe, Germany.
Heber
Ralf
R
Boos
Irene
I
Göttmann
Dieter
D
Heinrich
Dirk
D
D000230:Adenocarcinoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D002408:Catheters, Indwelling / Q000009:adverse effects; D018450:Disease Progression; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial / Q000295:instrumentation; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011859:Radiography; D016019:Survival Analysis; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D014656:Vascular Surgical Procedures; D016387:Women's Health
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator