Long-term follow-up of neoadjuvant intraarterial chemotherapy using an original four-lumen double-balloon (4L-DB) catheter for locally advanced uterine cervical cancer

Int J Clin Oncol. 2009 Feb;14(1):56-62. doi: 10.1007/s10147-008-0801-3. Epub 2009 Feb 20.

Abstract

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).

Conclusion: 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.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Catheterization, Peripheral / instrumentation*
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Doxorubicin / analogs & derivatives
  • Drug Administration Schedule
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Hysterectomy
  • Infusions, Intra-Arterial
  • Kaplan-Meier Estimate
  • Middle Aged
  • Mitomycin / administration & dosage
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Radiotherapy, Adjuvant
  • Time Factors
  • Treatment Outcome
  • Uterine Cervical Neoplasms / drug therapy*
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / radiotherapy
  • Uterine Cervical Neoplasms / surgery

Substances

  • Mitomycin
  • Doxorubicin
  • pirarubicin
  • Cisplatin