摘要
目的:探讨单用卡铂(CBP)、单一疗程的子宫动脉栓塞性化疗并阴道动脉结扎在宫颈癌新辅助化疗(neoadjuvant chemotherapy,NACT)中的临床运用效果。方法:收集2007年1月至2009年12月我院宫颈癌患者69例,根据治疗方式不同分为结扎+化疗组31例和常规栓塞化疗组38例,常规栓塞性化疗组患者以卡铂结合明胶海绵颗粒行双侧子宫动脉栓塞性化疗;结扎+化疗组31例患者在以卡铂结合明胶海绵行双侧子宫动脉栓塞性化疗的同时结扎双侧阴道动脉;运用电子计算机体层扫描(CT)在化疗前和化疗后3周分别测量宫颈病灶大小变化,对两组的疗效、化疗副作用、阴道动脉结扎并发症和广泛子宫切除+盆腔淋巴结清扫术的情况进行比较。结果:结扎+化疗组31例患者中肿块完全消退(CR)与肿块部分消退(PR)分别是19.4%(6/31)、80.6%(25/31),总有效率100%,组织学CR3例,占9.7%;常规栓塞化疗组38例患者中CR与PR分别是5.3%(2/38)、71%(27/38),总有效率76.3%,9例病情无明显好转,比较两组总有效率之间差异有显著性(P<0.05);两组患者无严重骨髓抑制发生,无肝肾功能损害;结扎+化疗组无泌尿系统和直肠损伤发生,未增加广泛子宫切除的手术难度和并发症的发生。结论:单用卡铂、单一疗程的子宫动脉栓塞性化疗并阴道动脉结扎在缩小巨块型宫颈癌患者局部病灶方面得到了满意的临床效果,其操作简单易行、安全有效。
Objective To evaluate the effects of a single course of neoadjuvant chemotherapy （NACT） with combination of uterine artery embolization plus carboplatin and vaginal artery ligation in patients with bulky cervical cancer. Methods 69 patients with bulky cervical cancer enrolled in our hospital from January 2007 to December 2009 were divided into ligation plus Chemoembolization group （31 cases） with bilateral uterine artery embolization with gelatin foam containing carboplatin plus bilateral vaginal artery ligation,and routine Chemoemboliation group （38 cases） with bilateral uterine artery embolization with earboplatin alone. Ttumor size was measured both before and after three weeks treatment with neoadjuvant chemotherapy by using CT. Therapeutic effects,complications of bilateral vaginal artery ligation,side effects of Chemoembolization,state of Radical Hysterectomy and Pehie lymph node dissection were observed. Results The patients in ligation plus Chemoemboliation group obtained a satisfactory therapeutic effect, the total effective rate, CR, PR, and histological CR were 100%, 19.4% （6/31）, 80.6% （25/31） and 9.68% （3 eases） respectively. But in Chemoembolization alone group, the total effeetive rate, CR, PR were 76.3% （29/38）, 5.3% （2/38）, 71% （27/38） respectively. There was significant difference in excellent effective rate （P 〈 0.05）between these two groups. In all patients received surgcry and ehemotherapy, no severe bone marrow suppression, liver and kidney impairment was observed. And no urlnaU system and recta damage occurred in ligation plus Chemoembolization group, without increasing the difficulty and complications of Radical Hysterectomy and Pelvic lymph node dissection. Conclusion Our data revealed that a single course treatment of combination of bilateral uterine artery embolization with carboplatin plus bilateral vaginal artery ligation is a simple and safe operation with satisfactory therapeutic effects and minor side effects in bulky cervical cancer.
出处
《实用医学杂志》
CAS
北大核心
2011年第2期209-212,共4页
The Journal of Practical Medicine
基金
贵州省卫生厅基金资助(编号:D-284)
关键词
宫颈肿瘤
子宫动脉
新辅助化疗
阴道动脉
结扎
卡铂
Cervical neoplasms
Uterine artery
Neoadjuvant chemotherapy
Vaginal artery ligation
Carhoplatin
