介入性化疗在宫颈癌手术前的应用  

Application of interventional chemotherapy to cervical cancer before operation.

作　　者：刘萍[1] 陈春林[1] 梁立治[2] 马奔[1] 刘佩鸣[1] 谭道彩[2] 杜洪[3] 

机构地区：[1]广州市第一人民医院妇产科,510180 [2]中山医科大学肿瘤医院妇科,广州510089 [3]广州市第一人民医院病理科,510180

出　　处：《中国实用妇科与产科杂志》2001年第11期666-668,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨宫颈癌术前介入性化疗的临床疗效、病理学改变及癌组织内的药物浓度。方法　对 47例宫颈癌患者实施术前介入性化疗 ,抗癌药物选择卡铂、表阿霉素或阿霉素 ;部分病例在灌注化疗 (2 / 3量抗癌药物 )后用携带有抗癌药物 (1/ 3量 )的明胶海绵颗粒栓塞肿瘤供血动脉 ;7例患者检测了化疗后宫颈癌组织内铂离子浓度。结果　 47例宫颈癌中 32例 (32 / 32 )Ⅱ期、9例 (9/ 11)Ⅲa期、2例 (2 / 4)Ⅲb期经 1～ 3次术前介入性化疗后可顺利手术切除 ;术后标本病理切片中可见大量坏死组织及淋巴细胞浸润 ,其中组织学完全缓解 (HCR) 9例 ;7例检测了宫颈癌组织内的铂离子浓度 ,发现动脉灌注后癌组织内铂离子浓度明显高于静脉灌注。结论　宫颈癌术前介入性化疗可有效提高癌组织内的抗癌药物浓度 ,缩小肿瘤体积 。Objective To evaluate the therapeutic effects,pathological changes and concentration of anticarcinogen in the tumor tissues in patients with cervical cancer after interventional chemotherapy.Methods Forty-seven cases of cervical cancer were performed chemotherapy by interventional method with carboplatin,epirubicin or ADM before operation.Some of them were performed the arterial chemoembolization with gelfoam particles mixed with 1/3 total drug dose after 2/3 total drug dose perfusion through the bilateral feeding arteries.Concentrations of Pt\+\{2+\} in the tumor tissues of 7 cases were measured after the operation.Results Forty-three patients[32(32/32)Ⅱ,9(9/11)Ⅲa,2(2/4)Ⅲb stage]were resectable after 1 to 3 times of treatment.Mass necrosis and lymphocyte cells infiltration were found in the tumor tissue.Nine cases were noted histological complete recovery(HCR)clinically.The concentrations of Pt\+\{2+\} in the tumor tissues of 7 cases through the arterial way were higher than that of intravenous chemotherapy.Conclusion The pre-operative interventional chemotherapy is proved to be effective in increasing the concentration of drugs in tumor tissue as well as in reducing tumor size.Some patients can reach HCR.

关 键 词：宫颈癌 介入性化疗 疗效 

分 类 号：R737.33[医药卫生—肿瘤] R730.53[医药卫生—临床医学]