５‐ＦＵの持続動注をベースとしたＣＤＤＰの少量連日動注　進行子宮頚癌を対象として

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  • Intra-arterial chemotherapy low-dose consecutive CDDP combined with continuous 5-FU for advanced or recurrent cervical cancer.
  • ―進行子宮頚癌を対象として―

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There are three key points concerning the efficacy of CDDP in clinical use. First, anti-tumor response to CDDP is correlated not with Cmax but with AUC (area under the curve). Secondarily, antitumor response to chemotherapy and survival of patients receiving chemotherapy is directly correlated with the dose intensity (DI : mg/m2/wk) of CDDP in advanced gynecologic cancer which is CDDP-sensitive. To augment AUC and DI, we developed a unique mode of administration—that is low-dose consecutive (LDC) CDDP (10 mg/m2, day 1∼7) for intravenous administration. Successful clinical results with this method were already reported in both ovarian and uterine cancer. Lastly, CDDP can augment anti-tumor efficacy of 5-FU which is entirely time-dependent agent. Thus, we designed continuous 5-FU combined with LDC-CDDP, which were administered through the catheter whose tip is placed in the aorta abdominalis utilizing an external infuser pump for advanced or recurrent cervical cancer, whose lesion is limited within the pelvis. The present modality delivered a response rate (CR+PR/evaluable) of 62.4% out of 93 patients with recurrent cerival cancer in the pelvis after radiotherapy with significant survival impact. Further, this modality was also effective as a neoadjuvant for advanced cervical adenocarcinorma with response rate of 68.2% out of 22 cases. Generally, the rate of complete surgery performed for stage II patients has been lower than 20%. In contrast, we performed complete surgery in 16 patients out of 22 with stage IIb or IIIb following neoadjuvant chemotherapy (NC), with 6 having incomplete surgery. Thus, the present modality is considered to be promissing for advanced malignancies whose lesion is located in the pelvis.

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