DSA下多支超选择性动脉灌注化疗联合手术治疗中晚期乳腺癌的临床疗效分析

目的:探讨中晚期乳腺癌多支超选择性动脉化疗联合手术治疗的临床应用价值。方法:60例经临床穿刺活检病理明确诊断为乳腺癌的患者,随机分为2组,A组为介入化疗组(30例),采用Seldinger’s方法术前在DSA造影下多支供血动脉分别超选择性插管,靶血管区域化疗栓塞。B组为对照组(30例),采用术前常规外周静脉全身注药新辅助化疗,2组化疗方案均用吡柔比星联合紫杉醇。比较两组的近期、远期疗效,生存率,复发率,疗程、并发症及化疗不良反应。结果:A组完全缓解(CR)6例(20.0%),部分缓解(PR)23例(76.7%),稳定(SD)1例(3.3%),CR+PR 29例(96.7%),平均疗程时间(29.8±3.2)d,A组复发5例16.7%),中位生存期39个月。B组CR 1例(3.3%),PR 22例(73.3%),SD 7例(23.3%),CR+PR23例(76.7%),平均疗程时间(39.9±4.5)d,复发16例(53.3%),中位生存期25个月。A组完全缓解率、部分缓解率及有效率均高于对照B组(P<0.05)。平均疗程低于对照组,复发率降低且生存时间延长。结论:中晚期乳腺癌术前多支供血动脉超选择性插管,靶血管区域化疗栓塞可明显提高疗效,降低临床分期,降低化疗不良反应及并发症,增加手术切除机会,减少术中出血和缩短手术时间,降低复发率。

Multi-branch superselective arterial infusion chemotherapy combined with surgical treatment for advanced breast cancer

Objective:To study the effect of multi-branch superselective arterial chemotherapy combined with surgical treatment in advanced breast cancer.Methods:All 60 cases of breast cancer were randomly divided into two groups,group A of interventional chemotherapy group(30 cases),using Seldinger’s method of preoperative angiography in the DSA under the multi-branch artery.super-selective insertion tube,target vessel region chemoembolization.B was the control group(30 cases),to use routine preoperative systemic peripheral intravenous injection of neoadjuvant chemotherapy,chemotherapy regimens: pirarubicin combined with paclitaxel.Results:In group A there were complete remission(CR) in 6(20.0%),partial remission(PR) 23 cases(76.7%),stable(SD) 1(3.3%),CR + PR 29 cases(96.7%),the average treatment time(29.8 ± 3.2) d,5 cases were recurrent 16.7%),median survival 39 months.In group B there were CR 1(3.3%),PR 22(73.3%),SD 7(23.3%),CR + PR 23 cases(76.7%),the average treatment time(39.9 ± 4.5) d,recurrence in 16 patients(53.3%),median survival time 25 months.Group A complete remission rate,partial response rate and effective rate were higher than the control group B(P<0.05).The average course of treatment was shorter than the control group,reduced the relapse rate and prolonged survival.Conclusion:Multi-branch artery preoperative superselective catheterization,embolization target vessel region can significantly improve the efficacy and reduce the clinical stage,reducing adverse reactions and complications of chemotherapy,reduce the relapse rate for advanced breast cancer.