Randomized comparison of intra-arterial chemotherapy versus intra-arterial chemotherapy and gelfoam embolization for treatment of advanced cervical carcinoma

Cardiovasc Intervent Radiol. 2005 Nov-Dec;28(6):736-43. doi: 10.1007/s00270-004-4178-z.

Abstract

Purpose: We evaluated the effects of intra-arterial infusion therapy by comparing the results obtained with a combination of intra-arterial anticancer drugs with and without transcatheter arterial embolization (TAE) in patients with cervical cancer.

Methods: Between April 1999 and March 2003, intra-arterial therapy was administered to 45 patients (mean age 49 years) with cervical cancer. Of these, 18 had stage IIb , 4 had stage IIIa, 19 had stage IIIb, and 4 had stage IVb cancer; the histopathologic types were squamous cell carcinoma (n = 35), adenocarcinoma (n = 8), and adenosquamous carcinoma (n = 2). A total of 45 patients gave their informed consent and were randomized on a continuous basis into one of three groups according to the therapeutic protocols: group A consisted of 15 patients who received cisplatin, group B consisted of 17 patients who received cisplatin, mitomycin, doxorubicin hydrochloride, and 5-fluorouracil, and group C consisted of 13 patients who received cisplatin and TAE. Each protocol was administered twice with a 3 week interval between treatments. The efficacy of treatment was evaluated on the basis of the tumor reduction ratio (%) using MR imaging and the side effects were analyzed.

Results: In groups A, B, and C, the tumor reduction ratio was 54%, 84%, and 86%, respectively; it was significantly greater in groups B and C than in group A (p < 0.01). The difference between groups B and C was not statistically significant. Although all group C patients developed severe pain after TAE, the pain was controlled with analgesics. Thrombocytopenia occurred in 6 of 17 (35%) group B patients.

Conclusion: Group B and C patients had better tumor reduction than those in group A. Fewer hematologic complications occurred in group C patients compared with group B.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antibiotics, Antineoplastic / adverse effects
  • Antibiotics, Antineoplastic / therapeutic use
  • Antimetabolites, Antineoplastic / adverse effects
  • Antimetabolites, Antineoplastic / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Carcinoma / diagnosis
  • Carcinoma / drug therapy
  • Carcinoma / therapy*
  • Cervix Uteri / pathology
  • Cisplatin / adverse effects
  • Cisplatin / therapeutic use
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / methods
  • Doxorubicin / adverse effects
  • Doxorubicin / therapeutic use
  • Drug Therapy, Combination*
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Female
  • Fluorouracil / adverse effects
  • Fluorouracil / therapeutic use
  • Gelatin Sponge, Absorbable / adverse effects
  • Gelatin Sponge, Absorbable / therapeutic use*
  • Hemostatics / adverse effects
  • Hemostatics / therapeutic use*
  • Humans
  • Infusions, Intra-Arterial / methods
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Mitomycin / adverse effects
  • Mitomycin / therapeutic use
  • Treatment Outcome
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / therapy*

Substances

  • Antibiotics, Antineoplastic
  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents
  • Hemostatics
  • Mitomycin
  • Doxorubicin
  • Cisplatin
  • Fluorouracil