Neoadjuvant intra-arterial chemotherapy using an original four-lumen double-balloon catheter for locally advanced uterine cervical cancer
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Tomohito Tanaka1, Yoshito Terai1, Satoe Fujiwara1, Yoshimichi Tanaka1, Hiroshi Sasaki1, Satoshi Tsunetoh1, Kazuhiro Yamamoto2, Takashi Yamada3 and Masahide Ohmichi1
1Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Japan
2Department of Radiology, Osaka Medical College, Takatsuki, Japan
3Department of Pathology, Osaka Medical College, Takatsuki, Japan
Yoshito Terai, email: firstname.lastname@example.org
Keywords: uterine cervical cancer; locally advanced uterine cervical cancer; neoadjuvant chemotherapy; radical hysterectomy
Received: June 05, 2018 Accepted: December 13, 2018 Published: December 28, 2018
OBJECTIVE: We report a balloon-occluded arterial infusion therapy with an original four-lumen double-balloon catheter (4L-DB) which allows for the efficient injection of an anticancer agent at a high concentration to the target spot for patients with locally advanced uterine cervical cancer.
METHODS: One hundred and forty-three patients with locally advanced cervical cancer treated with neoadjuvant intra-arterial chemotherapy (NAIAC) or a primary radical hysterectomy (PRH) were retrospectively assessed. The patients in the NAIAC group received irinotecan 70 mg/m2 intravenously on day 1 and 8 and cisplatin 70 mg/m2 intra-arterially using the 4L-DB on day 2 of a 21-day course, and two courses were performed in principle. The radical hysterectomy was performed within 6 weeks after NAIAC.
RESULTS: Ninety-four patients were treated with NAIAC, and 49 patients undertook a PRH. The response rate of NAIAC on MRI was 92.6%. Fourteen patients (14.6%) had no evidence of cancer cells on pathologic diagnoses. The NAIAC group had a longer disease-free survival than the PRH group (p=0.02); however, the overall survival was not significantly different. The relative risk (RR) for recurrence was higher in patients with lymph node metastasis (RR, 4.31; 95% CI, 2.23-8.43) and lower in those who underwent NAIAC (RR, 0.30; 95% CI, 0.14-0.68).
CONCLUSION: Our results with NAIAC using the 4L-DB catheter in locally advanced cervical cancer indicates beneficial effects on primary lesions and improves disease-free survival.
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