术前介入化疗治疗巨块型宫颈癌52例疗效分析  

Efficiency of intra-arterial neoadjuvant chemotherapy before radical excision in 52 patients with cervical cancer

作　　者：于月成[1] 汪海丹 辛晓燕[1] 李贵容[1] 赵海波[1] 王滨[1] 

机构地区：[1]第四军医大学西京医院妇产科,陕西西安710033 [2]解放军82医院肿瘤中心,江苏淮安223001

出　　处：《第四军医大学学报》2004年第6期557-559,共3页Journal of the Fourth Military Medical University

摘　　要：目的 :研究和探索术前新辅助介入化疗治疗巨块型宫颈癌的方法和可行性 ,评价其对宫颈癌的治疗效果及对根治术的辅助价值 .方法 :选取 1 998 0 9/ 2 0 0 0 0 1就诊的 5 2例巨块型宫颈癌患者 ,术前采用顺铂 5 0mg/m2 、5 氟尿嘧啶 1 0 0 0mg/m2 、丝裂霉素 2 0mg/m2 方案进行子宫动脉介入化疗 2～ 3疗程 ,并对有手术适应证者及时实行宫颈癌根治术 .结果 :介入化疗后 1 2例完全缓解 (CR) ,2 8例部分缓解 (PR) ,8例无变化 (NR) ,4例疾病进展 (PD) ,总有效率为 77% ,与化疗前相比肿瘤体积显著缩小 (P <0 .0 5 ) ,对其中 5 0例患者成功实施了宫颈癌根治术 .术后病理发现淋巴结转移者中CR1例 ,PR4例 ,NR或PD8例 ,均为盆腔淋巴结转移 .所有患者均未发生严重的化疗或手术并发症 .结论 :术前介入化疗可缩小宫颈癌病灶 ,并能减少淋巴结转移和复发 ,是一种安全有效的治疗方法 .AIM: To explore the feasibility and therapeutic efficiency of intra arterial neoadjuvant chemotherapy before radical excision in patients with cervical cancer. METHODS: Fifty two female patients with cervical cancer were enrolled into the study and were treated with a 2 3 course of intra arterial neoadjuvant chemotherapy immediately after the pathological diagnosis. The regime included 50 mg/m 2 DDP, 1000 mg/m2 5 FU and 20 mg/m 2 MMC. Then radical excision was performed in those who were good for the operation. RESULTS: Complete recovery (CR) was acquired in 12 patients and partial recovery (PR) in 28 patients. The total response rate was 76.9%, with no recovery (NR) in 8 and progressed disease (PD) in 4 of 52 cases after 2 courses of intra arterial neoadjuvant chemotherapy. The tumor size reduced significantly ( P <0.05) after neoadjuvant therapy and the radical excision was preformed successfully in 50 patients. Pathological examination revealed pelvic lymphatic metastasis in 1 of 12CR, 4 of 28 PR, and 8 of NR or PD. No serious side effects related to the chemotherapy or operation were observed in all the patients. CONCLUSION: Intra arterial neoadjuvant chemotherapy before radical excision not only is helpful for operation but also can reduce metastasis and recurrence. It can extend patients' survival time and improve life quality.

关 键 词：宫颈肿瘤 化学栓塞 治疗性 

分 类 号：R730.53[医药卫生—肿瘤]