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

本研究的目的是评价局部晚期宫颈癌患者接受经皮盆腔灌注联合体外化学滤过（PPPEC）动脉灌注化疗的缓解率和生存率。选择23例未经治疗的Ⅲ a ~ Ⅳ a期宫颈癌患者，PPPEC单用超大剂量顺铂（140- 250 mg/m2）或超大剂量顺铂联合丝裂霉素C（10 mg/例）、培洛霉素（10 mg/例）和5-氟尿嘧啶（1000 mg/例），间隔2周，共2次。18例确诊为肿瘤降级的患者在PPPEC后接受了根治性手术。其余5名患者接受了放射治疗。第二次PPPEC后2周，中位肿瘤体积缩小率为76.4%，肿瘤有效率为86.9%，组织学有效率为95.6%，肿瘤分期下降率为82.6%。手术治愈率为88.9%。5年无进展生存率为47.4%，5年生存率为73.7%，PPPEC下超大剂量动脉灌注化疗可有效降低肿瘤分期，提高局部晚期宫颈癌患者的5年生存率。

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.