子宮頚部扁平上皮癌動注化学療法効果判定のためコルポスコピーの有用性について

Forty-three patients with atage II squamous cell carcinoma of the uterine cervix were treated with intra-arterial cis-platinum before radical hysterectomy. The dose of cis-platinum was 50mg/㎡ and the infusion was repeated twice at 3-week intervals. In this in investigation, serial colposcopy and biopsies were performed to assess the efficacy of this chemotherapy. On colposcopy, the first change on the surface of the lesion during chemotherapy was a whitish change, followed by a yellowish change. After that, the lasion became less irregular, atypical vessels were less numerous and the surface was civered with squamous epithelium. On patho-logical examination of the resected meterials following radical hysterectomy, viable tumor cells had disappeared in 7 (group 1) and remained in 36 (group 2) patients. Retrospective investigation revealed a significant difference in colposcopic findings between groups 1 and 2, one week after the first chemotherapy. In regard to the remaining viable tumor cells, the pathological examination using serial biopsies revealed a significant difference between groups 1 and 2, 5 weeks after the first chmotherapy. Thus, the present results indicate that colposcopy is clinically effective in the early evaluation of the efficacy of intra-arerial injection on uterine cervical carcinoma.

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