多支超选择性动脉化疗联合手术治疗中晚期乳腺癌  

Multi pie Selective Arterial Chemotherapy Combined with Surgery in the Treatment of Advanced Breast Cancer

作　　者：许彪[1] 庄亚强[1] 刘惕生[1] 陈刚[1] 韦力谦[1] 

机构地区：[1]广西医科大学第五附属医院放射科介入室,广西柳州545006

出　　处：《实用放射学杂志》2011年第6期925-928,949,共5页Journal of Practical Radiology

基　　金：广西卫生厅科技计划项目（编号：Z2008413）.

摘　　要：目的探索中晚期乳腺癌多支超选择性动脉化疗联合手术治疗临床应用价值。方法60例经穿刺活检诊断乳腺癌患者，随机分2组，A组为介入治疗组（30例），采用术前多支供血动脉分别超选择性插管，靶血管区域化疗栓塞。B组为对照组（30例），采用术前常规外周静脉给药新辅助化疗，2组方案均用吡柔比星联合紫杉醇。观察近期、远期疗效，疗程、并发症及副作用。结果A组完全缓解（CR）5例（16．7％），部分缓解（PR）23例（76．7％），稳定（SD）2例（6．7％），CR＋PR28例（93．3％），平均疗程时间（29．8±3．2）d，A组复发9例（30％），中位生存期37个月。B组CR2例（6．7％），PR21例（70％），SD7例（23．3％），CR＋PR23例（76．7％），平均疗程时间（39．9±4．5）d，复发16例（53．3％），中位生存期25个月。A组完全缓解率、部分缓解率及有效率均高于对照B组（P〈0．05）。平均疗程低于对照组。复发减少且生存时间延长。结论中晚期乳腺癌术前多支供血动脉超选择性插管，靶血管区域化疗栓塞可明显提高疗效，降低临床分期，增加手术切除机会，减少术中出血和缩短手术时间。Objective To evaluate the clinical application value of multiple selective arterial chemotherapy combined with surgery in the treatment of advanced breast cancer. Methods 60 patients with breast cancer confirmed by percutaneous biopsy were randomly divided into two groups ： interventional treatment group （ group A, 30 cases）, underwent and target-vessel revascularizations regional chemotherapy embolization preoperatively using by multiple selective intubation in blood supply arteries in breast cancer. Control group （group 13,30 cases）treated preoperatively with conventional peripheral vein to neoadjuvant chemotherapy drugs. The pirarubicin and paclitaxel were all used in two groups. The recent and long-term efficacy, complications and side effects were observed. Resuits In group A,the conditions of the patients were complete remission（CR） in 5 eases（ 16.7 %）, partial remission （PR） in 23 cases （76.7%） ,steady （SD） in 2 cases （6.7%） , CR plus PR in 28 cases （93.3%） ,the average period of time was （29.8 ± 3.2） days,9 cases （30 %） recurred and the median survival time was 37 months. In group B,CR in 2 cases （6.7 %）, PR in 21 cases （70 %） ,SD in 7 cases （23.3%） ,CR plus PR in 23 cases （76.7%） were showed , the average period of time was （ 39.9 ± 4.5 ） days , 16 cases （ 53.3%） recurred and the median survival time was 25 months. The rates of CR, PR and effective rate were higher than those of group B （P〈 0.05 ） ,and the average treatment course was lower than those of the control group, the recurrent decreased and survival period was longer in group A. Conclusion For advanced breast cancer,preoperative selective intubation, regional chemotherapy embolization can obviously improve the curative effect, reduce the clinical stages,improve the surgical resection, reduce bleeding and the time of surgery.

关 键 词：乳腺 乳腺癌 化疗栓塞 介入放射学 

分 类 号：R737.9[医药卫生—肿瘤] R815[医药卫生—临床医学]