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术前介入化疗治疗巨块型宫颈癌52例疗效分析
引用本文:于月成,汪海丹,辛晓燕,李贵容,赵海波,王滨.术前介入化疗治疗巨块型宫颈癌52例疗效分析[J].第四军医大学学报,2004,25(6):557-559.
作者姓名:于月成  汪海丹  辛晓燕  李贵容  赵海波  王滨
作者单位:1. 第四军医大学西京医院妇产科,陕西,西安,710033
2. 解放军82医院肿瘤中心,江苏,淮安,223001
摘    要:目的: 研究和探索术前新辅助介入化疗治疗巨块型宫颈癌的方法和可行性,评价其对宫颈癌的治疗效果及对根治术的辅助价值. 方法: 选取1998-09/2000-01就诊的52例巨块型宫颈癌患者,术前采用顺铂50 mg/m2、5-氟尿嘧啶1000 mg/m2、丝裂霉素20 mg/m2方案进行子宫动脉介入化疗2~3疗程,并对有手术适应证者及时实行宫颈癌根治术. 结果: 介入化疗后12例完全缓解(CR),28例部分缓解(PR),8例无变化(NR),4例疾病进展(PD),总有效率为77%,与化疗前相比肿瘤体积显著缩小(P<0.05),对其中50例患者成功实施了宫颈癌根治术. 术后病理发现淋巴结转移者中CR1例,PR4例,NR或PD8例,均为盆腔淋巴结转移. 所有患者均未发生严重的化疗或手术并发症. 结论: 术前介入化疗可缩小宫颈癌病灶,并能减少淋巴结转移和复发,是一种安全有效的治疗方法.

关 键 词:宫颈肿瘤  化学栓塞  治疗性
文章编号:1000-2790(2004)06-0557-03
修稿时间:2003年11月12

Efficiency of intra-arterial neoadjuvant chemotherapy before radical excision in 52 patients with cervical cancer
Abstract:AIM: To explore the feasibility and therapeutic efficiency of intra arterial neoadjuvant chemotherapy before radical excision in patients with cervical cancer. METHODS: Fifty two female patients with cervical cancer were enrolled into the study and were treated with a 2 3 course of intra arterial neoadjuvant chemotherapy immediately after the pathological diagnosis. The regime included 50 mg/m 2 DDP, 1000 mg/m2 5 FU and 20 mg/m 2 MMC. Then radical excision was performed in those who were good for the operation. RESULTS: Complete recovery (CR) was acquired in 12 patients and partial recovery (PR) in 28 patients. The total response rate was 76.9%, with no recovery (NR) in 8 and progressed disease (PD) in 4 of 52 cases after 2 courses of intra arterial neoadjuvant chemotherapy. The tumor size reduced significantly ( P <0.05) after neoadjuvant therapy and the radical excision was preformed successfully in 50 patients. Pathological examination revealed pelvic lymphatic metastasis in 1 of 12CR, 4 of 28 PR, and 8 of NR or PD. No serious side effects related to the chemotherapy or operation were observed in all the patients. CONCLUSION: Intra arterial neoadjuvant chemotherapy before radical excision not only is helpful for operation but also can reduce metastasis and recurrence. It can extend patients' survival time and improve life quality.
Keywords:cervix neoplasms  chemoembolization  therapeutic
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