Intra-arterial nitrogen mustard in advanced pelvic malignancies

Abstract A group of 20 patients with pelvic malignancies were treated with intraarterial nitrogen mustard with a one- or two-injection technique to administer the entire dosage. The patients had cervical, fundal, and ovarian carcinomas but in each instance the lesion had spread beyond the confines of the organ of origin. Fifteen of these patients had been treated “to tolerance” and had evidences of active recurrence, giving them an exceedingly limited prognosis initially. Five patients were selected for treatment prior to the administration initially. Five patients were selected for treatment prior to the administration of the radiation. With 3 of the patients still living—2 without evidence of disease and one with evidence of disease—the average survival for the entire group is approximately twelve months. The posttreatment morbidity was considerably more marked, however, in the patients whose radiation had preceded the administration of the HN2. The animal studies using rabbits failed to indicate an increased mortality rate when sublethal doses of radiation and mustard were used together without regard for the sequence of administration or the time interval. Clinically, it is not felt that this particular technique of mustard administration yields enough benefit, even in the far-advanced pelvic malignancies, to merit the risk of morbidity which it entails.