自体骨髓移植用于妇科恶性肿瘤治疗的研究  

Study of Autologous Bone Marrow Transplantation in the Treatment of Gynecologic Carcinoma

作　　者：涂持坤[1] 孟玉春 林永熙[1] 郝淑琴[1] 史文琴[1] 王得玲[1] 杨学琪[1] 

机构地区：[1]天津市第一中心医院妇科

出　　处：《中华妇产科杂志》1995年第8期475-478,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：采用自体骨髓移植并大剂量化疗治疗妇科恶性肿瘤６例，其中卵巢癌４例，输卵管癌２例。临床ＩＩＩ期１例，ＩＶ期４例，Ｉｃ期１例。采骨髓后，环磷酰胺和卡铂分别从静脉或腹腔给药，总剂量达常规剂量的２．５～５倍，化疗后还输骨髓。结果：因有自体骨髓移植支持，６例患者均能耐受这种大剂量化疗，其中２例曾因不能耐受常规化疗而中止治疗１年余。本组病例未出现明显＊外毒性，无一例因治疗死亡；本组术后残存癌者４例，治疗后完全缓解３例，部分缓解１例；移植后无瘤生存６月以上者占５／６．移植后随访时间１５～３２个月，平均（中位数）２６个月，６例生存期１２～５３个月，平均为２８个月，４例ＩＶ期患者生存期１２～３０个月，平均２４个月。提示：经本治疗后患者可免除长期多疗程循环化疗，生命质量提高。bjective To investigate the role of autologous bone marrow transplantation(ABMT)in patients with gynecologic carcinoma treated by high-dose chemotherapy. Methods This was a presentation of four patients with ovarian carcinoma,two patients with pri- mary fallopian tubal carcinoma , and 5/6 of them clinically staged as IIl and IV,treated with combina- tion chemotherapy of cytoxan and carbeplatin by intraperitoneal and intravenous infusion,the dose being 2. 5～5times those employed conventionaly. Autologous bone marrow collection and storage were con- ducted under strictly sterile conditions. Chemotherapy was given pre-and post-operatively and ABMT was performed immediately after chemotherapy. Careful follow-up was observed at monthly intervals. Results All of the six patients tolerated the treatment well,with no death within a median follow- up of 26 months(range 15～32).Five of them lived more than 6 months with no evidence of disease. Two patients without gross residual tumor,who could not tolerate conventional chemotherapy which had to be discontinued,successfully received high-dose chemotherapy,supported by ABMT. All four patients with gross residual tumor benefited by immediate clinical remission after treatment.Median sur- vival for all patients was 28 months(range 12～53),median survival for stage IV patients was 24 months(range12～30). Conclusions Patients subjected to high-dose chemotherapy supported by ABMT are exempted from suffering the cyclic multiple courses of chemotherapy,repeated or long-term hospitalization and may lead a life of good quality.

关 键 词：骨髓移植 女性 生殖器肿瘤 药物疗法 自体移植 

分 类 号：R735.305[医药卫生—肿瘤] R457.7[医药卫生—临床医学]