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Randomized Comparison of Intra-Arterial Chemotherapy Versus Intra-Arterial Chemotherapy and Gelfoam Embolization for Treatment of Advanced Cervical Carcinoma

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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.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1 Honjo, Kumamoto, 860-8505, Japan

    O. Ikeda, N. Mizukami, Y. Murata, A. Arakawa & Y. Yamashita

  2. Department of Obstetrics and Gynecology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1 Honjo, Kumamoto, 860-8505, Japan

    H. Katabuchi & H. Okamoto

  3. Department of Radiology, Kumamoto City Hospital, 1-1-60 Kotoh, Kumamoto, 860-8505, Japan

    T. Yasunaga

  4. Department of Obstetrics and Gynecology, Kumamoto City Hospital, 1-1-60 Kotoh, Kumamoto, 860-8505, Japan

    A. Tsunawaki

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  1. O. Ikeda
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  2. N. Mizukami
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Correspondence to O. Ikeda.

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Ikeda, O., Mizukami, N., Murata, Y. et al. Randomized Comparison of Intra-Arterial Chemotherapy Versus Intra-Arterial Chemotherapy and Gelfoam Embolization for Treatment of Advanced Cervical Carcinoma. Cardiovasc Intervent Radiol 28, 736–743 (2005). https://doi.org/10.1007/s00270-004-4178-z

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  • DOI: https://doi.org/10.1007/s00270-004-4178-z

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