缓释型氟尿嘧啶植入剂应用于乳腺癌改良根治的安全性  

Safety of fluorouracil implants for modified radical mastectomy

作　　者：朱德淼[1] 

机构地区：[1]辽宁医学院附属第一医院乳腺外科,辽宁省锦州市121001

出　　处：《中国组织工程研究与临床康复》2010年第8期1471-1474,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:如何寻找更好的药物剂型、给药途径,使高浓度的药物直接作用于局部,并提高药物对局部靶组织的选择性、延长药物作用时间,对预防乳腺癌局部复发有重要意义。目的:探索在乳腺癌改良根治术中应用氟尿嘧啶植入剂的临床安全性,探寻预防乳腺癌局部复发的新途径。方法:63例乳腺癌改良根治术患者,TNM分期:Ⅰ+Ⅱ期35例,Ⅲ期28例,随机分为植入剂组32例及对照组31例,植入剂组在肿瘤下方,腋窝、锁骨下血管区域、胸大小肌之间多点喷撒氟尿嘧啶植入剂,总剂量为600mg,每点处小于100mg,观察应用植入剂后,切口有无感染裂开,8d后的皮下积液情况,皮瓣坏死、患肢水肿、拆线天数及血红、白细胞、肝肾功能情况。结果与结论:植入剂组与对照组在切口感染裂开、皮下积液量、患肢水肿、拆线天数及血红细胞计数等方面差异无显著性意义(P>0.05),两组治疗后,血白细胞计数、谷丙转氨酶、肌酐均较治疗前有明显增加(P<0.05),但是两组之间差异无显著性意义(P>0.05)。结果提示乳腺癌改良根治术中应用氟尿嘧啶植入剂是安全可靠的,是乳腺癌术后局部化疗的有效途径。BACKGROUND：It is of significance for looking for ideal pharmaceutical dosage form and administration route to make sure direct action in local region,improve selection of high-concentration drug to local target tissue,prolong drug action,and prevent local recurrence of breast cancer.OBJECTIVE：To explore the clinical safety of fluorouracil implants for modified radical mastectomy,and investigate the new way to prevent the local recurrence of breast cancer.METHODS：A total of 63 cases with breast cancer treated by modified radical mastectomy in TNM stage of Ⅰ＋Ⅱ（n=35）and Ⅲ（n=28）were randomly divided into control group（n=31）and implant group（n=32）.Fluorouracil implants（600 mg in total,less than 100 mg at each site）were multiple-implanted below the tumor and in the armpits,subclavian vascular region,and axillary vascular area,so as to observe the incision infection or dehiscence,the subcutaneous fluid volume after 8 days,flap necrosis,limb edema,stitches days,WBC,RBC,hepatic and renal function.RESULTS AND CONCLUSION：The differences in the incision infection or dehiscence,the subcutaneous fluid volume after 5 days,flap necrosis,limb edema,stitches days,and RBC between two groups were not significantly.Levels of WBC,glutamic-pyruvic transaminase,and creatinine were significantly increased after operation compared with before operation（P 0.05）,but there was no significant difference between the two groups（P 0.05）,suggesting that the method of implanting sustained-release fluorouracil for modified radical mastectomy was safe,and it might become an effective way to local chemotherapy for breast cancer postoperatively.

关 键 词：乳腺癌 改良根治术 氟尿嘧啶植入剂 安全性 缓释材料 药物控释系统及其载体材料 

分 类 号：R318[医药卫生—生物医学工程]