术前动脉灌注化疗治疗局部晚期宫颈癌疗效分析

术前动脉灌注化疗治疗局部晚期宫颈癌疗效分析

【摘要】 目的 观察动脉灌注介入化疗对局部晚期宫颈癌的治疗效果。方法 38例Ⅰb2期和Ⅱa期宫颈癌患者中16例行术前子宫动脉灌注介入化疗,用顺铂80 mg/m2,化疗2~3疗程。每次介入治疗间隔10~14 d。化疗后3~4周行广泛子宫切除术+盆腔淋巴结清扫术。22例直接行广泛子宫切除术+盆腔淋巴结清扫术两种治疗方法。结果 16例患者经介入化疗后CR 4例,PR 10例,总有效率为87.5%。所有患者化疗后均行手术切除。与直接手术患者比较,手术时间和出血量明显减少(P＜0.05,P＜0.005),术后病理发现肿瘤深肌浸润明显减少(P＜0.05)。结论 介入治疗对局部晚期以上宫颈癌有一定的近期疗效,可以提高手术切除率,是宫颈癌综合治疗的有效手段之一。

【Abstract】 Objective To observe the efficacy of Introarterial Chemotherapy in patients with Locally advanced stage uterine cervix ancer.Methods 16 patients had received the preoperative chemotherapy consisted of 2-3cycles of introarterial cisplatin 80 mg/m2 interval 10-14 days,followed by radical hysterectomy with pelvic lymphadenectomy and 22 patients had received radical hysterectomy with pelvic lymphadenectomy only in all thirty-eight cervical cancer patients staged asⅠb2 orⅡa.Results The number of CR,PR were 4 and 10 respectively in 16 patients received the preoperative introarterial chemotherapy.The total tumor regression rate was 87.5%.all 16 patients underwent radical hysterectomy with pelvic lymphadenectomy.To compared operative and pathologic data after radical hysterectomy in the two groups,there were significant differences in operating time,estimated blood loss(P＜0.05,P＜0.005).The ratio of cervical deep stromal invasion in introarterial chemotherapy group was lower than those in the immediate radical surgery group.Conclusion The short-term effective was observed in this study.The preoperative introarterial chemotherapy can decrease the tumor size and benefit to following radical surgery.It might be a good treatment option in patients with locally advanced cervical cancer.

【Key words】Uterine cervix cancer;Neoadjuvant chemotherapy;Arterial embolism

宫颈癌是妇科常见的恶性肿瘤,手术和放疗是主要的治疗手段。近年来,由于化疗药物的迅猛发展,化疗已经成为宫颈癌的重要辅助治疗手段。自从上世纪80年代开始,新辅助化疗逐渐应用于局部晚期宫颈癌,介入化疗作为一种有效的区域性化疗方法,已逐渐应用于宫颈癌治疗中,并取得了较为满意的疗效,使部分患者获得了手术机会。

1 资料与方法

1.1 一般资料 2007年4月至2009年7月我院收治的Ⅰb2期和Ⅱa期宫颈癌宫颈癌16例行动脉灌注介入化疗+广泛子宫切除术+盆腔淋巴结清扫术。与同期