Neoadjuvant high-dose intraarterial infusion chemotherapy under percutaneous pelvic perfusion with extracorporeal chemofiltration in patients with stage IIIa-IVa cervical cancer.

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The objective of this study was to evaluate the response rate and survival of patients with locally advanced uterine cervical cancer who were treated with intraarterial infusion chemotherapy under percutaneous pelvic perfusion with extracorporeal chemofiltration (PPPEC). Twenty three previously untreated patients with stage IIIa-IVa cervical cancer were enrolled in the study.PPPEC was administered twice at 2 weeks interval using super high-dose cisplatin alone (140-250mg/m^2) or super high-dose cisplatin plus mitomycin C (10mg/body), pepleomycin (10mg/body) and 5-fluorouracil (1000mg/body). Eighteen patients with confirmed tumor down-staging underwent radical surgery following PPPEC. Radiotherapy was administered on the remaining five patients. Two weeks aI~er the second PPPEC, the median volumetric tumor reduction and tumor response were 76.4% and 86.9%, respectively Histologic response was 95.6% while the tumor down-staging reached 82.6%. The curative surgery rate achieved was 88.9%. Five-year progression-free survival was 47.4% and 5-year survival rate was 73.7%.As conclusion, Super high-dose intraarterial infusion chemotherapy under PPPEC effectively achieved tumor down-staging and resulted in the favorable performance of the subsequent radical surgery hence improved the 5-year survival rate of patients with locally advanced uterine cervical cancer.