紫杉醇联合子宫动脉灌注化疗栓塞术在中晚期宫颈癌中的应用  

Application of paclitaxel combined with uterine artery transarterial chemoembolization in treatment of patients with middle and advanced cervical cancer

作　　者：何昌霞[1] 丁德权[1] 曹齐生[1] 

机构地区：[1]安徽省马鞍山市人民医院肿瘤介入病区,安徽马鞍山243000

出　　处：《实用临床医药杂志》2015年第11期57-60,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11520917)

摘　　要：目的探讨紫杉醇联合双侧子宫动脉经导管灌注化疗栓塞术（TACE）在中晚期宫颈癌中的应用及对癌组织微血管密度（MVD）的影响。方法 36例分期为ⅡB~ⅢB期的宫颈癌患者,行TACE术,化疗药物为：顺铂60~80 mg/m2;紫杉醇135~175 mg/m2。治疗2次后,分期下降有手术机会者立即行全子宫切除＋盆腔淋巴结清扫术,疗效不显著者,行同步放化疗。以免疫组化法检测肿瘤组织MVD。结果 TACE术后CR 7例,PR 24例,SD 4例,PD 1例,总反应率为86.11%。术后30例临床分期降期,进一步手术治疗,其术前MVD为（60.35±4.51）条/mm2,术后（42.68±5.09）条/mm2,两者差异有统计学意义（P〈0.01）。随访至2015年1月,3、5年生存率（OS）分别为72.22%、44.44%。结论紫杉醇联合TACE术可使部分中晚期宫颈癌患者获得手术机会,减少肿瘤组织血管生成,改善预后。Objective To explore the application of paclitaxel combined with bilateral uterine artery transarterial chemoembolization（ TACE） in treatment of patients with middle and advanced cervical cancer and the influence on microvessel density（ MVD） surrounding cancer tissues. Methods A total of 36 cervical cancer patients with staging ⅡB ~ ⅢB were treated with TACE. Chemotherapy drugs were cisplatin with the dose of 60 ~ 80 mg / m2 and paclitaxel with dose of 135 ~ 175 mg / m2. Patients underwent total hysterectomy and pelvic lymphadenectomy immediately after the tumor staging dropped if the condition allows. Otherwise the concurrent chemoradio therapy was performed when the effect was not significant. MVD of tumor tissue was detected by immunohistochemistry. Results There were 7 cases of CR,24 cases of PR,4 cases of SD and 1 case of PD,and the total response rate was 86. 11% after TACE. Totally 30 cases showed the tumor staging drop and then received surgery.MVD was（ 60. 35 ± 4. 51） line / mm2 before surgery while the density was（ 42. 68 ± 5. 09） line / mm2.After surgery,and the difference was statistically significant（ P〈0. 01）. Follow-up to January 2015,3-year survival（ OS） and 5-year survival（ OS） were 72. 22% and 44. 44% respectively. Conclusion Paclitaxel combined with TACE can bring opportunity of surgery for part pf patients with middle and advanced cervical cancer in order to reduce tumor angiogenesis and improve prognosis.

关 键 词：紫杉醇 经动脉导管灌注化疗栓塞术 中晚期宫颈癌 免疫组化 微血管 生存率 

分 类 号：R737.33[医药卫生—肿瘤]