Super-selective chemoembolization in locally advanced cervical cancer

DOI

https://dx.doi.org/10.18565/aig.2020.1suppl.98-104

Maksimov S.Ya., Khadzhimba A.S., Il’in A.A., Pletneva A.V., Smirnova M.P., Balakhnin P.V.
Saint-Petersburg clinical scientific and practical center for special types of medical care (oncology-oriented), Saint-Petersburg, Russia

Aim. To investigate the effectiveness of super-selective chemoembolization (SCE) in locally advanced cervical cancer.
Materials and methods. The study comprised 17 patients with stage IB2-IIIB cervical cancer who underwent SCE, which was performed using HepaSphere drug-loaded microspheres. Oxaliplatin (100 mg) was used as a cytostatic agent. The treatment response was evaluated by magnetic resonance imaging (MRI) 3 weeks after SCE.
Results. The best treatment response was observed in patients with stage IB2 disease. Stabilization was achieved in 4/17 (67%) patients. A partial response was observed in 2/17 (33%). In patients with stage IIA disease, a partial response was observed in 2/17 (67%) patients. In 1 patient, stabilization of the process was established. Among patients with stage IIIB disease, the best treatment response was achieved in 1 patient, who had a 13% reduction in tumor size. In the remaining 2 cases, the effect of treatment was negligible (5 and 6% tumor size reduction). About half (47%) of patients developed a postembolization syndrome.
Conclusion. To date, sufficient experience has not yet been gained to draw definite conclusions about the effectiveness of SCE. However, the fact that this treatment modality has all the advantages of intra-arterial chemotherapy while avoiding its adverse effects, its use may offer promising results.

cervical cancer

super-selective chemoembolization

uterine artery embolization

chemotherapy

microspheres

Full text (in Russian)

Каприн А.Д., Ашрафян Л.А., Стилиди И.С. Онкогинекология. Национальное руководство. М.: ГЭОТАР-Медиа, 2019. 47 с. [Kaprin A.D., Ashrafyan L.A. Stilidi I.S. Oncogynecology. National leadership. M.: GEOTAR-Media, 2019. 47 s. (in Russian)].
Кравец О.А., Кузнецов В.В., Морхов К.Ю., Нечушкина В.М. и др. Клинические рекомендации по диагностике и лечению рака шейки матки. М., 2014. [Kravets O.A., Kuznetsov V.V., Morkhov K.Yu., Nechushkina V.M., et el. Clinical recommendations for the diagnosis and treatment of cervical cancer. Moscow, 2014. (in Russian)]
Ашрафян Л.А., Антонова И.Б., Алешикова О.И., Добровольская Н.Ю. Хирургический этап как один из основных компонентов в комплексном лечении рака шейки матки IIb-IIIb стадии. Российский онкологический журнал. 2007; 3: 21–25. [Ashrafyan L.A., Antonova I.B., Aleshikova O.I., Dobrovolskaya N.Yu., Chazova N.L. Diagnostic criteria and predictors of the efficiency of neoadjuvant chemotherapy for locally advanced cancer (stages IIB—IIIB) of the cervix uteri. Rossiyskiy onkologicheskiy zhurnal. 2007; 3: 21–25. (in Russian)]
National Comprehensive Cancer Network. Guidelines for treatment of cancer by site. Cervical cancer. Version 5.2019. https://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf
Переводчикова Н.И., Горбунова В.А., ред. Руководство по химиотерапии опухолевых заболеваний. М.: Практическая медицина, 2018. 688 с. [Perevodchikova N.I., Gorbunova V.A., red. Rukovodstvo po khimioterapii opukholevykh zabolevaniy. M.: Prakticheskaya meditsina, 2018. 688 s. (in Russian)]
Seldinger S. I. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol. 1953; 39(5): 368–76. doi:10.3109/00016925309136722
Brooks B. The treatment of traumatic arterio-venous fistula. South Med J. 1930; 23: 100–6.
Baum S., Nusbaum M. The control of gastrointestinal hemorrhage by selective mesenteric arterial infusion of vasopressin. Radiology. 1971; 98(3): 497–505. doi: 10.1148/98.3.497.
Rosch J., Dotter C.T., Brown M.J. Selective arterial embolization. A new method for control of acute gastrointestinal bleeding. Radiology. 1972; 102(2): 303–6. doi:10.1148/102.2.303.
Oliver J.A. Jr., Lance J.S. Selective embolization to control massive hemorrhage following pelvic surgery. Am J Obstet Gynecol. 1979; 135(3): 431–2. doi: 10.1016/0002-9378(79)90721-x.
Regensberg C., Richard J.P., Doyon D., Frileux C. May hepatic artery embolization replace surgical desarterialization in hepatic tumors. Nouv Presse Med. 1973; 17(6): 593–603. PMID: 4142843
Doyon D., Mouzon A., Jourde A.M., Regensberg C., Frileux C. Hepatic, arterial embolization in patients with malignant liver tumours. Ann Radiol (Paris). 1974; 17(6): 593–603. [Article in French]. PMID: 4142843
Murray-Lyon I.M. Treatment of hepatic tumours by ligation of the hepatic artery and infusion of cytotoxic drugs. J R Coll Surg Edinb. 1972; 17(3): 156–61.
Yong-Song Guan, Qing He and Ming-Quan Wang. Transcatheter Arterial Chemoembolization: History for more than 30 Years. ISRN Gastroenterol. 2012; 2012: 480650. doi: 10.5402/2012/480650.
Бабаева Н.А., Ашрафян Л.А., Антонова И.Б., Алешикова О.И., Оводенко Д.В., Ивашина С.В. и др. Роль химиоэмболизации маточных артерий в лечении местнораспространенного рака шейки матки: аналитический обзор. Акушерство и гинекология: новости, мнения, обучение. 2017; 1(15): 16–21. [Babaeva N.A., Ashrafyan L.A., Antonova I.B., Aleshikova O.I., Ovodenko D.V., Ivashina S.V., et al. The role of chemoembolization of the uterine arteries in the treatment of locally advanced cervical cancer: review. Akusherstvo i ginekologiya: novosti, mneniya, obucheniye. 2017; 1(15): 16–21. (in Russian)]
National Comprehensive Cancer Network. Recent Updates to NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): NCCN Guideline with NCCN Evidence Blocks™ – Uterine Neoplasms Version 5.2019 [Электронный источник. URL: https://www.nccn.org/professionals/ physician_gls/recently_updated.aspx Дата обращения 13.01.2020]
Schirf B.E., Vogelzang R.L., Chrisman H.B. Complications of Uterine Fibroid Embolization. Semin Intervent Radiol. 2006; 23(2): 143–9. doi: 10.1055/s-2006-941444.
Wang Y., Wang G., Wei L.H., Huang L.H., Wang J.L., Wang S.J., et al. Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement. Chin J Cancer. 2011; 30(9): 645–54. doi: 10.5732/cjc.011.10050.
Сarabelli C., Zarrelli A., Gallo A., Visentin M.C. Multimodal treatment with neoadjuvant intraarterial chemotherapy and radical surgery in patients with stage IIIB-IVA cervical cancer. A preliminary study. Cancer. 1995; 76(6): 1019–26. doi: 10.1002/1097-0142(19950915)76:6<1019::aid-cncr2820760616>3.0.co;2-4
Katsumata N., Yoshikawa H., Kobayashi H., Saito T., Kuzuya K., Nakanishi T., et al. Phase III randomised controlled trial of neoadjuvant chemotherapy plus radical surgery vs radical surgery alone for stages IB2, IIA2, and IIB cervical cancer. Br J Cancer. 2013; 108(10): 1957–63. doi: 10.1038/bjc.2013.179

Received 06.12.2019

Accepted 25.12.2019

Sergey Y. Maksimov, MD, oncologist, professor. Head of gynaecological department, Saint-Petersburg clinical scientific and practical center for special types of medical care (oncology-oriented). E-mail: s.maximov@mail.ru. Тел.: +79219393753. http://orcid.org/0000-0003-3746-0855
197758 Russia, Saint Petersburg, set. Pesochniy, str. Leningradskaya, 68А let.A.
Angella S. Khadgimba, MD, oncologist. Gynaecological department, Saint-Petersburg clinical scientific and practical center for special types of medical care
(oncology-oriented). E-mail: khadzhimba@gmail.com. Тел.:+79219515855 http://orcid.org/0000-0002-8247-0238
197758 Russia, Saint Petersburg, set. Pesochniy, str. Leningradskaya, 68А let.A.
Anton A. Ilin, oncologist. Gynaecological department, Saint-Petersburg clinical scientific and practical center for special types of medical care (oncology-oriented).
E-mail: ilin.doc@gmail.com. Тел.:+79214104343. http://orcid.org/0000-0002-8309-8570
197758 Russia, Saint Petersburg, set. Pesochniy, str. Leningradskaya, 68А let.A.
Alesya V. Pletneva, resident. St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation. E-mail: alesyapletneva@list.ru. Тел.:+79214239738. http://orcid.org/0000-0001-5621-7549
194100 Russia, Saint Petersburg, str. Litovskaya 2.
Marta P. Smirnova, oncologist. Gynaecological department, Saint-Petersburg clinical scientific and practical center for special types of medical care (oncology-oriented).
E-mail: smirnova.mrp@gmail.com. Тел.:+79219562878. http://orcid.org/0000-0001-7387-7573
197758 Russia, Saint Petersburg, set. Pesochniy, str. Leningradskaya, 68А let.A.
Pavel D. Balahnin, PhD, oncologist. Head of x-ray surgery department, Saint-Petersburg clinical scientific and practical center for special types of medical care
(oncology-oriented). E-mail: balahnin_p@mail.ru. Тел.:+79119337953.
Russia 197758, Saint Petersburg, set. Pesochniy, str. Leningradskaya, 68А let.A.

For citation: Maksimov S.Ya., Khadzhimba A.S., Il’in A.A., Pletneva A.V., Smirnova M.P., Balakhnin P.V. Super-selective chemoembolization in locally advanced cervical cancer.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 1(Suppl): 98-104 (in Russian)
https://dx.doi.org/10.18565/aig.2020.1suppl. 98-104

Super-selective chemoembolization in locally advanced cervical cancer

Maksimov S.Ya., Khadzhimba A.S., Il’in A.A., Pletneva A.V., Smirnova M.P., Balakhnin P.V.

Keywords

References

About the Authors

Similar Articles