[Clinical evaluation of intra-arterial infusion chemotherapy for advanced or recurrent pelvic tumors with or without radiotherapy]

Abstract

We analyzed 97 cases of various advanced or recurrent pelvic tumors which were cervix, rectal, ovarian and other tumors treated by intra-arterial infusion chemotherapy (IAIC) with or without radiotherapy. The IAIC regimen was separated into two groups: group I consisting of 5-FU + MMC +/- ADR (54 cases) and group II consisting of CDDP + MMC +/- 5-FU (43 cases) from 1985. The catheter was placed in the bifurcation of abdominal aorta, and from 1990, the catheters were placed in bilateral internal iliac arteries (8 cases). The overall response rate (CR + PR) was 65%, 74% in patients receiving radiotherapy, and 47% in those without radiotherapy. There were no significant differences between each primary site and presence of radiotherapy combination in survival rate. Two-year survival rate and 5-year survival rate was 32% and 15% for all cases, and 65% and 33% for CR cases, respectively. A significantly better survival rate was obtained in patients with CR. Five-year survival rate was 4% in group I, and 35% in group II (p = 0.00216) by chemotherapy regimen. Severe (more than grade III) hematological acute side effects were 45% for all cases. In 8 cases in which the catheters were placed in internal iliac arteries, there were severe skin ulcers in 2 cases, and severe pain of leg or gluteal region requiring narcotics in 3 cases. These data suggest that IAIC mainly with cisplatin with or without radiotherapy is one of the effective treatment for advanced or recurrent pelvic tumors. Also, we should check blood flow distribution periodically, and control the concentration of drugs.