Efficacy of the High Dose Mitomycin-C Intrabifurcation of Aorta Infusion for Treatment of Squamous Cell Car cinoma of Cervix Stage II B - III B

Abstract

The neoadjuvant single high dose chemotherapy for induction the high clinical complete regression with low toxicities, following by radical hysterectomy and pelvic lymphadenectomy produced high pathological complete regression and favourable survival time. This procedure was used instead of standard radiotherapy in treatment of squamous cell carcinoma of the uterine cervix stage II B -III B who refused the radiation treatment. 

The intrabifurcation of aorta by Mitomycin-C 35 mg/m2 single infusion was performed in 36 new cases, revealed the clinical complete regression 86.1% and partial regression 5.6% after chemotherapy 4-6 weeks. Twenty eight patients with clinical complete regression were treated by radical hysterectomy and pelvic nodes dissection, which showed pathological complete regression in 39.3%, small residual cancer in the cervix encountered in 39.3% and residual cancer in the cervix and/or positive pelvic nodes accounted for 21.4%. The bone marrow was moderately depressed in the second week after treatment but experiencing tolerable non-haematolgic toxic effects. 

The recurrence rate occured 25.0% after radical surgery and oral chemotherapy. The over all 5-years survival rate was 75.0%. The follow up period until August 1992 showed that the survival time ranged from 6.5-101.5 months (median 93.5 months). The 5-years survival rate of the pathological complete regression group was 100.0%, and 88.2% for the residual cancer group. (Thai J Obstet Gynaecol 1994;6:1-6.)