Abstract
Fourteen patients with advanced cervical cancer (FIGO stage II b ; 2, III b ; 10 and N a ; 2) received neoadjuvant chemotherapy (NAC) with intra-arterial infusion. The patients underwent radiation therapy (FIGO stage III b, n=17) and the survival rate was compared. Patients were treated with consecutive infusion of CDDP (10mg/day) and continuous infusion of 5-fluorouracil (250 mg/day) from bilateral intra iliac arteries in each course for 10 days. Complete response and partial response was achieved in 3 and 9 patients, respectively, and the total response rate reached 85.7%. Eleven patients received radical hysterectomy after NAC. NAC was effective for pelvic lymph node metastasis in all six patients. However it was not effective for para-aortic lymph nodes metastasis. Among the patients with stage III b, an 80% 3-year survival rate and a 60% 4-year survival rate were obtained. Significantly higher survival rates of NAC in 3- and 4-year olds were found in the patients who received NAC and not of the patients who received radiotherapy. Lung, bone and para-aortic lymph node metastasis was found in 3 out of 4 patients. However, 7 out of 10 patients in the radiation group alone were found to have intra-pelvic recurrence. No obvious side effect was found during NAC. NAC with intra-arterial infusion chemotherapy is effective for advanced cervical cancer. From the present study, it is suggested that additional intra-venous chemotherapy and/or radiation therapy for extra-pelvic metastasis is required to improve the survival rate for advanced cervical cancer.
