Analysis of the results of selective chemoembolization of the uterine arteries in the complex treatment of locally advanced cervical cancer

Objective: to evaluate the results of selective chemoembolization of the uterine arteries (HEMA) in the complex treatment of locally advanced cervical cancer (LACC). Materials and methods: Selective HEMA using carboplatin AUC 4 was performed in 29 patients with stages IBC - IIIC1. The average age of patients was 45.8 years. The average cervical volumebefore treatment was 88.3 cm3. Patients with exophytic forms of tumor dominated (44%), a mixed form of tumor occurred in 24% of patients, and an endophytic form was registered in 32% of patients.A comprehensive examination included magnetic resonance imaging of the pelvic organs with intravenous contrast, 3D ultrasound examination of the pelvic organs, determining the level of the SCC tumor marker, cystoscopy and sigmoidoscopy / colonoscopy. All patients were assessed for hemodynamic parameters of intratumoral blood flow and blood flow in the uterine and ovarian arteries before treatment and on the 7th, 14th, 21st day after HEMA.Results: a significant decrease in tumor volume after HEMA was established: it ranged from 16 cm3 to 63 cm3, in average 36.6 cm3. The largest decrease in volume (76.3%) was observed in patients with exophytic forms of the disease. A significant decrease in the number of intratumoral vessels and blood flow velocity and an increase in the resistance index were revealed. According to the results of the histological examination of postoperative material, therapeutic pathomorphism in the tumor was detected in all cases. Pathomorphosis of the 1st, 2nd and 3-4th degrees was observed in, respectively, 42.8, 31.4 and 25.8% of patients.The long-term results of overall and relapse-free survival 3 years after treatment were as following: mortality was 24%, relapses were detected in 10 patients (35%), mainly due to distant metastasis, and local relapses were noted in 2 patients (6.8%).Conclusion: it is advisable to include selective HEMA in the complex treatment of patients with LACC. The use of this method is especially promising in patients with an exophytic form of tumor accompanied by bleeding.