Superselective uterine artery chemoembolization for treatment of locally advanced cervical cancer / 中华放射学杂志

ABSTRACT

Objective To investigate the efficacy of uterine artery chemoembolization in the treatment of locally advanced cervical cancer.Methods A total of 268 patients with locally advanced cervical cancer were treated with uterine artery chemoembolization in our department.The stage distribution among the patients included 132 stage Ⅰ B2,85 stage Ⅱ A1 and 51 stage Ⅱ A2.There were 223 patients of squamous cell carcinoma,24 patients of adenocarcinoma,9 patients of adenosquamous carcinoma,small cell carcinoma of the 7 patients,5 patients of neuroendocrine carcinoma.Transcatheter uterine artery infusion of paclitaxel and nedaplatin,gelatin sponge particles was applied for uterine artery embolization.The clinicopathological parameters were analyzed,and their impacts on tumor response were investigated.RECIST criteria were used to evaluate the response in solid tumors.Student t test was used to compare cervical tumor diameter before and after treatment,and Chi-square test was used for comparison of categorical data.Follow up examinations included pelvic ultrasound,gynecology,vaginal stump cell smears.Results Of the 268 patients,74 (27.6％) patients showed a complete response,160 (59.7％) patients had a partial response to uterine artery chemoembolization,and the overall response rate was 87.3％.A total of 258 (96.3 ％) patients underwent surgery,and pathological complete response were identified in 46 (17.2％).Forty (14.9％) patients were found to have lymph node metastasis after surgery.Response rates of stage Ⅰ B2 and Ⅱ A cases were 94.7％ and 80.1％,respectively,P ＜ 0.05.Patients with squamous cell carcinoma showed a better response rate than patents with other pathological types (94.2％ vs.53.3％),P ＜ 0.05.Initial tumor volume and cycles of preoperative uterine artery chemoembolization had no effect onthe response rate.Conclusions Uterine artery chemoembolization can increase the rate of surgical resectionof patients with locally advanced cervical cancer and can improve the reaction rate with tolerable side effect.It is an applicable option of treatment for patients with locally advanced cervical cancer in the neoadjuvanttreatment.