摘要
目的 对比子宫动脉介入栓塞与PICC静脉用药新辅助化疗治疗局部进展期宫颈癌的近期疗效及远期预后.方法 研究入选98例Ⅰb～Ⅱb期宫颈癌患者并随机分为动脉介入组（A组53例）与静脉用药组（B组45例）,前者通过双侧子宫动脉介入并栓塞实施术前化疗,后者通过PICC实施术前化疗,对比两组近期疗效,术后随访24个月,对比远期复发率与生存率.结果 ①术前化疗结束后14 d,两组患者瘤体均明显缩小,A组化疗后瘤体平均最大直径显著小于B组;两组化疗疗效构成不同,动脉介入组总体有效率高于静脉用药组,差异有统计学意义（P〈0.05）.②两组不良反应主要有胃肠道反应、骨髓抑制、肝功能损害、末梢神经损害等,以上不良反应发生率差异无统计学意义（P＞0.05）,栓塞引起的邻近器官损伤为介入化疗特有不良反应.结论 宫颈癌患者术前采用子宫动脉介入栓塞联合DDP＋TAX方案较之PICC静脉用药方案能提高近期疗效,更有利于实施宫颈癌根治手术,但要注意对邻近非靶向器官的损害.
Objective To compare the short term efficacy and long term prognosis between uterine artery interventional embolization and PICC intravenously therapy in neoadjuvant treatment of locally advanced cervical carcinoma. Methods 98 admitted cases of I b - IIb locally advanced cervical carcinoma in July 2009 - June 2011 were included and randomly divided into artery intervention group （ A group, 53 cases） and intravenous medication group （B group, 45 cases）. The former group was treated with bilateral uterine artery interventional embolization neoadju- vant chemotherapy （ NACT）. The latter group was treated with PICC implemented NACT. The short - term efficacy of the two groups was com- pared, and all the patients were followed - up for 24 months after surgery to compare the recurrence rate and survival rate. Results ①At 14 days after completion of NACT, the tumor volume of two groups were significantly reduced, and the mean maximum diameter of tumor of artery interven- tional chemotherapy group after NACT was significantly less than PICC group. The constitution of short term efficacy of two groups after NACT was statistically different. The overall efficiency of arterial intervention group was higher than that of PICC group, and the difference was not significant （ P 〉 O. 05 ）. ② Gastrointestinal reaction, bone marrow suppression, liver function damage, peripheral nerve damage were the main adverse reac- tions of two groups, which had no significant difference （ P 〉0.05）. The adjacent organ damage caused by interventional embolization was the specific adverse reactions of neoadjuvant chemotherapy. Conclusion Compared with PICC intravenous medication scheme in treatment of cervicalcancer, NACT of uterine artery interventional embolization combined with DDP ＋ TAX regimen can largely improve the short term efficacy, and more eondueive to the implementation of radical operation. However, the physicians must pay attention to the damage to the adjacent non -targeted organ.
出处
《临床和实验医学杂志》
2014年第3期210-213,共4页
Journal of Clinical and Experimental Medicine
关键词
进展期宫颈癌
新辅助化疗
动脉介入
栓塞
PICC
疗效
预后
Locally advanced cervical carcinoma
Neoadjuvant chemotherapy
Artery intervention
Embolization
Peripherally InsertedCentral Catheter
Efficacy
Prognosis
