Effect Of The Interventional Therapy For Locally Advanced Cervical Cancer

Cervical cancer is the most common gynecologic malignancy,and it threatens women's health seriously. In recent years, it isincreasing in incidence year by year and it intends to occur inyounger women. Therefore, the concept of the therapy for cervicalcancer is innovative. It includes treating the disease sufficiently,raising the survival rate, improving postoperative life quality of theyoung and early-stage patients. Currently, the therapy for cervicalcancer still contains surgery and radiotherapy mainly. It may gainbetter effect for early-stage patients, but it is not ideal for locallyadvanced patients. Furthermore, the side effect of radiotherapy issevere, it could make young patients appear symptoms ofperimenopause in advance, so the patients' quality of life is lower. Inthe past, many scholars considered that cervical cancer especiallysquamous carcinoma was not sensitive to chemotherapy relatively,so it was only used for patients with advanced stage or relapsedcervical cancer as one part of combine therapies. In recent years,chemotherapy is more effective for carcinoma of cervix uteri withthe rapid development of the chemotherapy, clinical research,medicine, the administration route and methods. Foreign andnational scholars paid more attention to the chemotherapy forcervical cancer. After Feri defined neoadjuvant chemotherapy(NACT)first time in 1982, foreign and national scholars began to applyneoadjuvant chemotherapy before surgery or radiotherapy forcervical cancer. They got content effect and increased survival rate.The administration route of neoadjuvant chemotherapy for cervicalcancer is intravenous or intraarterial. Intraarterial administration hasbeen shown to be more effective than intravenous administration inthe therapy for cervical cancer.Interventional chemotherapy could kill tumor cells with highdrug concentration in tumor tissue, shrink the tumor size, lesseninvolvement with tissue adjacent to it, decrease lymph nodemetastasis and stage, so it is helpful for operation. It can prolongpatients' survival time and improve life quality.Objective: To investigate the effect and clinical significance ofinterventional chemotherapy and embolization in the treatment oflocally advanced cervical cancer.Methods: Interventional group: Drug perfusion andembolization of uterine arteries by superselective catheterization wasperformed in 43 patients with locally advanced cervical cancerconfirmed by clinical examination and pathology, which included 3cases in stage IIA, 23 cases in stage IIB, 12 cases in stage IIIA and 5cases in stage IIIB. At the same time, hydration, antivomit drug andsymptomatic treatment were used. The chemotherapic program wascisplatin 80-120mg, adriamycin 80-120mg, 5-fluorouracil1000-1250 mg, mitomycin 8-20mg, cyclophosphamide 400-800mg,each time three or four kinds of drug were used simultaneously. Thetherapy was repeated after 2-5weeks and every cases was treatedwith 1-3 courses. Radiotherapy group: External irradiation wasperformed in 28 patients with locally advanced cervical cancerconfirmed by clinical examination and pathology, which included 18cases in stage IIB, 6 cases in stage IIIA and 4 cases in stage IIIB.Routine diremption and accelerator linear X-ray were used. The totaldosage was 40-50 Gy, each time for 2 Gy, 5 times a week,20-25times in all. The age, stage and pathotype had no significantdifferences between the two groups. We compared the differences ofshort-term effect rate, lymphatic metastasis and long-term survivalrate between the two groups.Results: The tumor size reduced significantly (p<0.05) afterinterventional therapy. The effect rate of stage II was significantlyhigher than stage III(p<0.05), but there was no significant differencebetween squamous carcinoma and adenocarcinoma (p>0.05). Thetotal effect rate of interventional and radiative therapy was 58.1%and 64.3%. There was no significant difference for the short-termeffect rate between the two groups in stage II and III (p>0.05). 26cases in interventional group got the chance of receiving a secondaryoperation and 17 cases in radiotherapy group, and there was nostatistically significant difference between the two groups (p>0.05).Postoperative pathological examination revealed that pelviclymphatic metastasis of interventional group was significantly lowerthan that of radiotherapy group (p<0.05). There were no differencesfor gastrointestinal reactions and WBC counts between the twogroups (p>0.05). There was no significant difference for survival rateof 1 year between the two groups (p>0.05), but 3-year survival forthe same stage of interventional group was significantly higher thanthat of radiotherapy group (p<0.05).Conclusion:1. Interventional therapy for cervical cancer can shrink tumorsize significantly and decrease the lymph node metastases rate, thetotal effect rate of interventional therapy was 58.1%. And the earlierthe stage is, the better the effect is.2. The short-term effect rate of the interventional therapy is assame as that of radiotherapy for cervical cancer.3. Interventional therapy for cervical cancer can raise 3-yearsurvival rate.4. Interventional chemotherapy is one effective and safe way tolocally advanced cervical cancer and it become one effective way tothe combine therapies for cervical cancer.