[Effect of preoperative chemotherapy on bulky cervical cancer by internal iliac arterial infusion].
OBJECTIVE
To evaluate the effect of preoperative chemotherapy on bulky cervical cancer by internal iliac arterial infusion.


METHODS
One hundred and eighty-six patients with bulky cervical cancer were randomly divided into two groups: chemotherapy + radiotherapy group (C + R group, n = 105) and radiotherapy group (R group, n = 81). Patients in C + R group underwent internal iliac arterial infusion chemotherapy by using Seldinger technique internal iliac arterial or epigastric arterial catheterization. Combined regimens were prescribed including cisplatin as the major drug. Meanwhile 192Ir high-dose-rate intracavitary radiotherapy was performed, with A point dose at 12 - 24 Gy/2-4 times (C + R group). Patients in R group were only given radiotherapy. Both groups of patients received radical hysterectomy two weeks after radiotherapy.


RESULTS
The tumor regression rate of C + R group was 97.1%, significantly higher than 79.0% in R group (P < 0.01). The effective rate for clinical Ib stage cancer in C + R group was 100.0%, significantly higher than 78.3% in R group (P < 0.01), but for clinical IIa, IIb stage cancers, the effective rate between two groups had no obvious difference (P > 0.05). Postoperative pathologic examinations showed the percentage of cervical tumor residue, parauterine invasion, pelvic lymph node metastasis in C + R group was lower than those of R group (P < 0.01). The 2-year recurrent rate in R group (23.5%) was higher than that of C + R group (6.7%, P < 0.01), but 2-year survival rate between two groups had no obvious difference.


CONCLUSIONS
Internal iliac arterial infusion chemotherapy can effectively reduce tumor volume, decrease lymph node and subclinical metastasis rates and postoperative recurrence rate; it can also improve radical resectability of patients with stage IIb cervical cancer. But the effect on long-term survival rate needs to be further evaluated through long-term follow-up of patients.
Chen
Yi-Le
YL
Department of Gynecologic Oncology, Hunan Province Tumor Hospital, Changsha 410006, China.
He
Guo-Qiang
GQ
Wang
Er-Dong
ED
D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008875:Middle Aged; D057234:Preoperative Period; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects / Q000528:radiation effects; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D055815:Young Adult
D002945:Cisplatin