Neoadjuvant intraarterial chemotherapy with cisplatin for treatment of advanced cervical cancer

Abstract

Objective: Patients with primarily inoperable, advanced cervical cancer- should be brought into an operable stage. Selective angiography and preoperative application of cisplatin into both artery uterine is a therapeutic option with low risks and side effects by this intraarterial application a significant higher intratumoral cisplatin concentration can be reached in comparison to systemic application of cisplatin.

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Method: 40 patients suffering from inoperable primary cancers (37 squamous epitel carcinoma, 3 adenocarcinoma) underwent preoperative intraarterial cisplatin infusion 2-3 limes into both artery uterine with a dose up to 25 to 50 mg of cisplatin on each side. The representation of the pelvic vessels has been done angiographical both artery uterine have been selected and up to 25 to 50 mg of cisplatin was injected with a perfusor on each side. Due to the known radiosensibilisation caused by cisplatin. 14 patients have been treated additionally with a preoperative intracavitary irradiation 2-3 times (6 Gy each) due to bleeding on the time of clinical admission of the patients.

Results: The 40 patients were 27-77 years old. At the time of diagnosis, the clinical stage according to the International Federation of Gynecology and Obstetrics (FIGO) classification included 18 x Figo II, 18 x Figo III and 4 x Figo IV. 32 patients (80%) had a complete or partial response: on 27 patients (Ci 7.5%) a Wertheim Operation could be performed. 8 patients showed stable disease or progressive disease, especially the two adenocarcinoma were nonresponder. Serious side effects of the therapy did not occur.

Conclusion: Regional cisplalin therapy by selective angiography of both artery uterine in combination with preoperative intracavitary irradiation is recommended at advanced cervical cancer to reach an operable stale of primarily nonoperable patients. The rate of response was 80%. Toxic side effects could not be found.