[Chemotherapy repeated injection via pelvic retroperitoneal cannulation]

To investigate the feasibility of chemotherapy for lymphatic metastases of gynecologic cancer by repeated injection via pelvic retroperitoneal cannulation.

5-fluorouracil (5-FU), thiotepa, methofrexate were repeatedly injected into the pelvic retroperitoneal space of 25 dogs and 24 patients respectively via cannulation. Microscope and high-performance liquid chromatography were used to observe the drug concentration of 5-FU and pathologic changes of the involved tissues.

Animal experiment showed no toxicity to vessels, ureter and the normal tissues involved; nodal 5-FU concentration of repeated injection side was 7 to 9 times of that on the peripheral connective tissue (P < 0.05). Clinical study revealed: (1) the external iliac, hypogastric, obturator, deep inguinal and most of the common iliac lymph nodes were submerged in the 5-FU solution; (2) pelvic and periaortic nodal 5-FU concentrations of repeated injection side were 20 to 73 and 27 to 110 times of that on single injection side respectively; nodal 5-FU concentration was 11 to 20 times of that on the peripheral connective tissue; (3) metastatic cancer cells of nodal in the study group showed obvious degeneration and necrosis while no changes in the control; (4) no severe complications or adverse effects were observed.

Repeated injection via pelvic retroperitoneal cannulation was feasible and probably more effective for the treatment of lymphatic metastases of gynecologic cancer.