Interventional techniques in the treatment of cervical cancer

  With the development and improvement of interventional techniques, their application in the treatment of malignant tumors with predominantly local growth is becoming more and more widespread. Cervical cancer develops slowly and important factors affecting its prognosis include tumor grading, pelvic lymph node metastasis, depth of infiltration and invasion of lymphatic and vascular gaps. In terms of treatment, local treatment is the main focus. The pelvic cavity, because of its special location, makes the lesions easy to remain and recur locally after surgery and radiotherapy for middle and late stage tumors. In recent years, interventional techniques play a role in the treatment of the following cervical cancers  1. preoperative neoadjuvant chemotherapy for locally progressive cervical cancer. Cervical cancer is mainly squamous cancer, and most of them are sensitive to cisplatin, and cisplatin is dose-dependent, which means that the higher the dose, the better the efficacy, and interventional therapy (local arterial infusion chemotherapy) makes the local drug concentration of tumor much higher than intravenous chemotherapy. Many studies have demonstrated that the tumor shrinkage rate and tumor remission of interventional therapy are significantly better than intravenous chemotherapy; preoperative interventional therapy helps to reduce the incidence of adverse prognostic factors (such as choroidal embolism, lymph node metastasis, parametrial infiltration, positive vaginal margin, ovarian metastasis) compared with intravenous chemotherapy; preoperative interventional therapy can reduce intraoperative bleeding; the incidence of adverse effects of interventional therapy is lower than that of intravenous chemotherapy.  2.Palliative treatment for advanced cervical cancer, recurrent cancer and difficult-to-control cancer. It is generally believed that high-dose infusion chemotherapy through pelvic artery has better efficacy for cancer foci appearing in the pelvis and is significantly better than intravenous administration. For cases of recurrence after surgery and radiotherapy, because of the poor local blood flow in the pelvis after surgery and radiotherapy, the concentration of systemic chemotherapeutic drugs in the local area is low, and the use of arterial infusion chemotherapy can directly increase the concentration of drugs in the local area and improve the therapeutic effect. In recent years, particle implantation, radiofrequency, freezing and other interventional minimally invasive techniques have made great progress in the treatment of tumors, especially particle implantation, which is simple and safe to operate, and is suitable for malignant tumors that are inoperable and have received sufficient radiotherapy and chemotherapy.  3.Embolytic therapy for cervical cancer bleeding. Hemorrhage of cervical cancer may occur in any period before and during treatment, which is the main cause of death of cervical cancer patients. When conservative treatment is ineffective, emergency action pulse embolization treatment should be performed with immediate effect.