HEMATO- AND NEPHROTOXICITY OF UTERINE ARTERY CHEMOEMBOLIZATION IN LOCALLY ADVANCED CERVICAL CANCER: SAFETY ASSESSMENT AND PROGNOSTIC MARKERS

Trifonov Fedor Aleksandrovich, Ivanov Sergey Anatolyevich, Kucherov Valery Vladimirovich, Petrosyan Artur Pavlovich, Nadinsky Dmitry Olegovich, Igolnikov Ilya Borisovich, Stekhova Armina Tigranovna

Relevance. Locally advanced cervical cancer (LACC) complicated by bleeding is a serious clinical problem that limits the possibilities of standard therapy. In this regard, uterine artery chemoembolization (UAC) is considered a promising method of local action, providing hemostasis and delivery of a chemotherapy drug directly to the tumor tissue. However, data on its toxicity and prognostic markers of efficacy remain insufficient. Materials and methods. A retrospective analysis of 69 patients with stage IIA–IIIB LACC who received UAC using cisplatin and lipiodol was performed. Safety assessment included monitoring of hematological and biochemical parameters before and after the procedure. Efficacy was assessed by the degree of tumor regression according to transvaginal ultrasound after 10–14 days. Results. The method showed a satisfactory safety profile: no pronounced hematological and nephrotoxicity was noted. The average tumor regression was 57%. Significant predictors of high efficiency of CEMA were: age over 43 years, left uterine artery diameter ≥2.71 mm, increased length of the afferent vessel, artery volume and cisplatin dose over 92 mg/m². Conclusion. CEMA demonstrated clinical efficacy and low toxicity, which allows us to consider it as a safe component of combined or palliative treatment for cervical cancer complicated by bleeding. The established prognostic markers can be used to personalize therapy.

Keywords:cervical cancer, chemoembolization, toxicity, tumor bleeding, tumor regression, prognostic markers.