肉瘤及癌性溃疡的术前化疗泵化疗  

Preoperative treatment of sarcoma and cancerous ulcer with intra-arterial chemotherapy

作　　者：范海涛[1] 李鼎锋[1] 苏秀云[1] 崔秋[1] 郭钧[1] 张平[1] 周举[1] 王磊[1] 姜维浩[1] 

机构地区：[1]军事医学科学院附属医院解放军307医院骨科,北京100071

出　　处：《中国肿瘤临床与康复》2008年第3期216-219,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的观察四肢软组织肉瘤及鳞癌性溃疡术前行皮下埋植式动脉化疗的疗效。方法自2003年7月至2007年11月治疗肉瘤及鳞癌性溃疡患者21例,男11例,女10例。年龄14～83岁,平均50岁。上肢6例,下肢15例。其中鳞癌6例,滑膜肉瘤4例,恶性纤维组织细胞瘤3例,脂肪肉瘤2例,骨肉瘤2例,恶性黑色素瘤2例,上皮样肉瘤1例,皮肤隆突性纤维肉瘤1例。癌性溃疡主要症状为疼痛、感染和出血;术前经化疗泵给予表阿霉素和顺铂,鳞癌加用博莱霉素,恶性黑色瘤加用氮烯咪胺,2～3周期后观察疗效。结果疼痛缓解总有效率(RR)为86.0%;溃疡愈合总有效率(RR)为71.0%;3例溃疡出血患者有明显止血效果;化疗后行手术13例,保留肢体手术11例,截肢手术2例。结论对于难治性肉瘤及癌性溃疡可采用皮下埋置式导向化疗,提高肿瘤区域的化疗药物浓度,有效控制肿瘤破溃所产生的疼痛、感染及出血症状,为手术创造了低血供及清晰的外科边界,减少复发率。Objective To observe the Clinical efficacy of preoperative treatment with subcutaneous implantable intra-arterial drug delivery system for soft tissue sarcoma of extremities and squamous cell （ SC ） cancerous ulcer. Methods From July 2003 to November 2007, 21 cases of sarcoma and SC cancerous ulcer were treated. Of them 11 were males and 10 were females and the ages were 14 - 83 （ average 50） years. Six case had upper limb lesions and 15 cases lower limb lesions. The pathologic diagnoses were： SC cancer 6 cases, synovial sarcoma 4 cases, malignant fibrohistiocytoma 3 cases, liposarcoma 2 cases, osteogenic sarcoma 2 cases, malignant melanoma 2 cases, epithelioid sarcoma 1 case, derma-eminence fibrosarcoma 1 case. The main symptoms of cancerous ulcer were pain, infection and hemorrhage. During preoperative treatment, epirubicin and cisplatin were given via the chemtherapy pump, bleomycin was added for SC cancer cases, dacarbazine was added for malignant melanoma cases. The curative effect was observed after 2-3 courses of treatment. Results The total effectiverate for relief of pain （RR） was 86.0% ; the total effec- tiverate of ulcer healing （RR） was 71.0%. Obvious hemostatic effect was observed in 3 patients who had hemorrhage due to ulcer. Operation was carried out in 13 cases after chemotherapy. Of them 11 cases had extremities preserved and other 2 cases underwent amputation . Conclusion Treatment with subcutaneous implantable intra-arterial drug delivery system can be used for refrectory sarcoma and cancerous ulcer to increase the concentration of chemotherapy medicines in the tumor region, to effectively control the pain, infection and hemorrhage due to cancerous ulcer, to provide low-blood-supply and clear surgical boundary and to reduce the recurrence rate.

关 键 词：肉瘤 癌性溃疡 动脉介入化疗 

分 类 号：R739.96[医药卫生—肿瘤]