摘要
[目的]探讨髂内脉灌注化疗及化疗栓塞术在中晚期宫颈癌治疗中的临床应用价值。[方法]30例中晚期宫颈癌Ⅱb-Ⅳ期,既往曾行放疗12例(Ⅱb 9例,Ⅲa 3例),全身化疗4例(Ⅲb 2例,Ⅳ2例),初治14例(Ⅱb 8例,Ⅲa 3例,Ⅲb 3例),全部病例行双侧髂内动脉灌注化疗术,并对合并出血6例行髂内动脉或子宫动脉栓塞术,治疗后疗效评价及毒性分析按RECISE及NCI CTC3.0标准判定。[结果]总有效率58%(CR 5例+PR 12例)。其中,6例(Ⅱb 5例,Ⅲa 1例)介入术后行全子宫切除+盆腔淋巴结清扫术,6例宫颈出血者止血效果佳。治疗后出现主要的化疗副反应,如消化道反应及骨髓抑制,24例出现发热,1例出现臀部皮肤破溃,经局部对症处理后好转。[结论]局部灌注化疗对于中晚期宫颈癌是有效综合治疗手段。
[Objective] To explore the clinical value of infusion chemotherapy and embolization via the internal iliae artery applied to the advanced and moderately advanced cervical cancer. [ Methods ] Thirty patients diagnosed as the advanced or moderately advanced cervical cancer in stages Ⅱb-Ⅳ were involved, in which 12 patients （9 Ⅱb ,3 Ⅲa） underwent radio-therapy and 4 patients （2 Ⅲb ,2 Ⅳ） underwent systemic chemotherapy previously, and 14 native patients （8 Ⅱb,3 Ⅲa ,3 Ⅲb）. All patients underwent the infusion chemotherapy via bilateral internal iliac artery, with embolization via internal iliac artery or the uterine artery for 6 patients complicated with hemorrhage. The therapeutic evaluation after the treatment and the toxicity are analyzed based on RECIST and NCI CTC 3.0 respectively. [ Results ] The overall response rate （OR） was 58% （5 CR and 12 PR）, 6 patients （5 Ⅱand 1 Ⅲa） underwent hysterectomy with pelvic lymphadenectomy after the in- tervention therapy. Satisfactory effect of hemostasis was observed in 6 patients complicated with cervical hemorrhage. The main side effects of chemotherapy such as gastrointestinal symptoms and myelosuppression were observed after the therapy, with 24 cases of fever and 1 case of skin rupture on hip, all of which were released after symptomatic treatments correspondingly. [ Conclusion] Local infusion chemotherapy can be adopted as an effective comprehensive therapy for advanced and moderately advanced cervical cancer.
出处
《大连医科大学学报》
CAS
2008年第2期143-145,共3页
Journal of Dalian Medical University
关键词
宫颈癌
化疗栓塞
中晚期
cervical cancer
chemotherapy embolization
advanced and moderately advanced malignancy.
