摘要
目的：探讨超选择动脉内灌注化疗加栓塞术前治疗Ⅰb～Ⅱa期宫颈癌的临床疗效。方法：1999年1月～2003年3月间收住院未经治疗的Ⅰb～Ⅱa期宫颈癌患者共64例，分成2组。对照组：33例，入院后直接行子宫颈癌根治术。观察组：31例，术前在数字减影血管造影术监视下，采用Seldinger技术行双侧髂内动脉插管灌注化疗药（铂类为主的联合方案），明胶海绵颗粒栓塞肿瘤供血明显的分支，2周后行子宫颈癌根治术。结果：观察组术前临床症状均有不同程度改善，显效率100％，且观察组巨块型宫颈癌患者对介入化疗栓塞的有效反应率为73．68％，其中完全缓解率为10．53％，部分缓解率为63．16％。观察组总的淋巴结转移、宫旁浸润（分别为6．45％、3．23％）均明显低于对照组（分别为39．39％、27．27％），两组比较有显著差异（P〈0．01）。观察组巨块型患者的淋巴结转移率（5．26％）明显低于对照组巨块型患者（46．67％），两组比较有显著差异（P〈0．05）j观察组2年复发率为3．23％，明显低于对照组的24．24％，两组比较有显著差异（P〈0．05）。观察组2年生存率为100％，对照组为93．93％，两组比较无显著差异（P〉0．05）。结论：术前应用超选择动脉内灌注化疗加栓塞可有效缩小肿瘤体积，消除盆腔内病理高危因素，减少术后复发率，可作为治疗具有不良预后高危因素早期宫颈癌（尤其是局部晚期宫颈癌）的常规辅助治疗方法。
Objective： To investigate the clinical effect of superselective intraarterial infusion chemotherapy （SACT） in patients with stage I b - I1 a cervical cancer before surgery. Methods： 64 previously untreated patients with stage Ⅰb～Ⅱa cervical cancer were divided into tow groups： control group （ surgery group, n =33） and study group （chemotherapy ＋ surgery group, n =31） . Patients instudy group underwent SACT by seldinger technique. Radical hysterectomy was administered two weeks after chemotherapy. Results ： The effective reactionrate in patients with local bulky tumor was 73.68% （ CR was 10. 53% and PR was 63. 16% ） . Postoperative pathologic examination showed total incidence of pelvic lymph node metastasis, parametrial infiltration in study group was significantly lower than that in control group （6. 45% and 3.23% vs 39. 39% and 27.27%, P 〈0.01 ）.The incidence of pelvic lymph node metastasis in patients with local bulky tumor in study group was significantly lower than that in control group （5. 26% vs 46. 47%, P 〈0.05） . The 2 - year recurrence rate for patients in study group was significantly lower than that in control group （3.23% vs 24. 24 % , P 〈0. 05） . But 2 -year survival rate between tow group had no obvious difference. Conclusion： SACT can effectively reduce tumor volum, eliminate the pathologic risk factors in the pelvic cavity and decrease the postoperative recurrence rate, it can be used as the routine adjunctive therapy in high - risk early - stage patients （especially locally advanced cervical cancer） .
出处
《中国妇幼保健》
CAS
北大核心
2008年第1期21-24,共4页
Maternal and Child Health Care of China
关键词
宫颈癌
动脉内灌注化疗
预后因素
Cervical cancer
Intraarterial infusion chemotherapy
Prognostic factor
