Subject(s)
Analgesia, Epidural/methods , Bupivacaine/therapeutic use , Leiomyoma/diagnosis , Pain/drug therapy , Pregnancy Complications, Neoplastic/drug therapy , Pregnancy Outcome , Uterine Neoplasms/diagnosis , Adult , Biological Availability , Bupivacaine/pharmacokinetics , Female , Humans , Leiomyoma/complications , Maternal Age , Pain/etiology , Pain Measurement/drug effects , Pregnancy , Pregnancy Complications, Neoplastic/diagnosis , Pregnancy Trimester, Second , Pregnancy, High-Risk , Risk Assessment , Uterine Neoplasms/complicationsABSTRACT
In two cases with adenosquamous cell carcinoma of advanced cervical cancer, carboplatin-based chemotherapy was given intraarterially from the internal iliac artery as neoadjuvant chemotherapy, and peripheral blood stem cells (PBSCs) were harvested. After the operation, conventional intravenous chemotherapy with PBSC autotransplant was performed. PBSCs were mobilized by neoadjuvant chemotherapy and G-CSF administration. By the apheresis procedures, 0.7-2.6 x 10(6)/kg CD34 positive cells were obtained. They had no severe side effects from intravenous chemotherapy with PBSCT, and they were free of disease 20 months. Neoadjuvant chemotherapy and G-CSF administration may be capable of mobilization of PBSCs, and chemotherapy with PBSCT may be useful in radioresistant advanced adenosquamous carcinoma of the cervical cancer.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carboplatin/administration & dosage , Carcinoma, Adenosquamous/therapy , Hematopoietic Stem Cell Transplantation , Uterine Cervical Neoplasms/therapy , Adult , Carcinoma, Adenosquamous/drug therapy , Carcinoma, Adenosquamous/surgery , Chemotherapy, Adjuvant , Combined Modality Therapy , Drug Administration Schedule , Epirubicin/administration & dosage , Etoposide/administration & dosage , Female , Granulocyte Colony-Stimulating Factor/administration & dosage , Humans , Middle Aged , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/surgeryABSTRACT
Combination chemotherapy including carboplatin was administered intraarterially from the internal iliac artery as neoadjuvant chemotherapy to nine patients with advanced uterine cervical cancer. Two or three courses were repeated at intervals of 3 weeks. And to investigate whether the administration of Lipo PGE1 with the action of vasodilation before intra-arterial chemotherapy increases tissue levels of anticancer agents, 7 out of 9 patients were treated with Lipo PGE1, followed by arterial infusion chemotherapy. After infusion, tissue platinum (Pt) concentrations were measured by flameless atomic absorption spectrophotometry. Three of 9 patients with measurable tumor had a complete response and 6 had a partial response. Tissue Pt concentrations reached maximum levels 2-6 hours after intra-arterial chemotherapy. Tissue Pt levels of the patients with pretreatment of Lipo PGE1 were significantly higher than those without pretreatment (p < 0.01). It seems likely that Lipo PGE1 administration before intra-arterial chemotherapy is useful for the enhancement of tissue levels of anticancer agents as well as the clinical effects.
