Long-term follow-up of neoadjuvant intraarterial chemotherapy using an original four-lumen double-balloon (4L-DB) catheter for locally advanced uterine cervical cancer.
BACKGROUND
We report the therapeutic potential, longterm survival, and toxicity of neoadjuvant intraarterial chemotherapy (NAIC) using an original four-lumen double-balloon (4L-DB) catheter followed by radical hysterectomy and/or radiotherapy in patients with locally advanced cervical cancer.


METHODS
Sixty patients with stage IIB-IVA cervical squamous cell cancer were treated with NAIC which included cisplatin (60-70 mg/m(2), day 1), mitomycin-C (10-20 mg/m(2), day 1), and pirarubicin hydrochloride (THP; 10-20 mg/m(2), day 1) for two courses every 21 days.


RESULTS
The median follow up among surviving patients was 93.7 months. Among 60 eligible patients, 22 had a complete response (CR; 36.7%) including 12 with a pathologic CR (20.0%). Thirty-six patients had a partial response (60.0%), and stable disease was observed in only 2 patients (3.3%). Moreover, we found that the platinum concentration in the cervix was correlated with the clinical response (P < 0.001). The 10-year progression-free survival (PFS) and 10-year survival were 90.9% and 90.9%, respectively, in patients with stage IIB disease and 66.0% and 70.7%, respectively, in patients with stage III disease. Leukopenia occurred in 86.7% of patients, but it was not very severe (grade 3, 4 in 13.3% of patients).


CONCLUSIONS
Our results with NAIC using the 4L-DB catheter in locally advanced cervical cancer demonstrate that a high platinum concentration has beneficial effects on primary lesions and improves long-term progression-free and overall survival.
Terai
Yoshito
Y
Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Osaka, Japan. gyn011@poh.osaka-med.ac.jp
Kanemura
Masanori
M
Sasaki
Hiroshi
H
Tsunetoh
Satoshi
S
Tanaka
Yoshimichi
Y
Yamashita
Yoshiki
Y
Yamamoto
Kazuhiro
K
Narabayashi
Isamu
I
Ohmichi
Masahide
M
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007261:Infusions, Intra-Arterial; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery
D016685:Mitomycin; D004317:Doxorubicin; C027260:pirarubicin; D002945:Cisplatin