45例妇科恶性肿瘤患者选择性动脉插管化疗临床分析

目的 探讨选择性动脉插管化疗对晚期和复发性妇科恶性肿瘤的治疗效果和不良反应。方法 回顾性分析1991年9月～2000年1月在我院接受选择性动脉插管化疗45例晚期和复发性妇科恶性肿瘤,其中卵巢恶性肿瘤31例、子宫恶性肿瘤6例、宫颈恶性肿瘤5例和绒癌3例。这些患者共完成选择性动脉插管化疗122次。结果 31例卵巢恶性肿瘤中有15例在动脉插管化疗后接受手术,其中11例达到满意或者较满意肿瘤细胞减灭术,有6例术后残留<2cm;另外4例只进行肿瘤部分切除。12例合并肝转移中有5例转移灶<3cm,经过肝动脉插管化疗后,肝转移灶消失。本组治疗总有效率(CR+PR)为26.7％。选择性动脉插管化疗的不良反应除与系统化疗相似,还有插管相关并发症,经积极治疗可以很好控制。结论 选择性动脉插管化疗对于治疗晚期和复发性、甚至难治性妇科肿瘤是一种有效的方法。

Transcatheter intraartenal chemotherapy in cases of recurrent and advanced gynecologic malignancies

Objective To determine the efficiency and adverse reaction of transcatheter into- arterial (IA) chemotherapy in the cases of recurrent and advanced gynecologic malignancies.Methods Retrospective analysis was made for 45 cases with recurrent and advanced gynecologic cancer, who received transcatheter IA chemotherapy combined with systemic chemotherapy between Sept. 1991 and Jan. 2000. 31 of them were ovarian neoplasms, 6 were uterine neoplasms, 5 were cervical neoplasms and 3 were choriocarcinoma. The transcatheter IA chemotherapy was totally completed in 122 times.Results 15 of 31 cases with ovarian carcinoma were received surgeries after transcatheter IA chemotherapy. 11 of them had optimal or suboptimal cytoreductive surgeries, while the residue was < 2 cm in 6 cases; another4 cases had only tumor partial surgeries. 12 of 45 cases with liver me-tastases had completed 36 times transcatheter liver arterial chemotherapy. The liver metastases with diameter < 3 cm in 5 cases disappeared after transcatheter LA chemotherapy. The overall response rate (CR + PR) was 26.7% . The adverse reactions of transcatheter IA chemotherapy were similar to the systemic chemotherapy, which could be well controlled and also there were pains and hemorrhage. Conclusions It is an effective method for transcatheter IA chemotherapy to treat the recurrent and advanced or even refractory gynecologic malignancies.