[Recent advances in intraarterial chemotherapy in gynecologic malignancy]

Anti-cancer chemotherapy (CTX) agents are mainly given intravenously (i.v.) in patients with gynecologic malignancy. The reasons intraarterial chemotherapy (IA-CTX) are not more commonly used are the following: 1) cervical, corpus, and ovarian carcinoma have shown an appreciable response to i.v. cisplatin-based chemotherapy, 2) locally advanced carcinoma, suitable for IA-CTX, is a potentially systemic disease, 3) IA-CTX often requires a special technique, 4) IA-CTX has not been a major concern for the Gynecologic Oncology Group (GOG) in the United States, and 5) the very small amount of medical evidence supporting IA-CTX makes cancer patients hesitate to give informed consent prior to receiving IA-CTX. The major concern of gynecologic oncologists has already moved away from the administration route of agents to new agents themselves including paclitaxel, docetaxel, and CPT-11. Looking again at the clinical data of IA-CTX as a neoadjuvant CTX for advanced cervical carcinoma reported in the 1990s, the response rate seems to be superior to that achieved by i.v.-CTX. Thus, we must now reappraise the IA-CTX for gynecologic malignancy.