PB方案在宫颈癌介入化疗中的应用

目的 探讨顺铂＋博莱霉素（PB）治疗方案在宫颈癌介入化疗中的应用效果。方法 采用P B方案,对64例ⅠB～ⅡB期宫颈癌病人术前均行双侧子宫动脉介入化疗栓塞术,观察化疗前后宫颈肿瘤体积变化及化疗后反应,评价介入化疗的效果。比较介入化疗后手术病人（观察组）与直接手术病人（对照组）术中情况及切除组织病理情况,评价介入化疗的近期疗效。长期随访病人,评价介入化疗的远期效果。结果 PB方案病人介入化疗的有效率为87.5%,缓解率为96.9%,34.4%的病人出现了发热反应,未见其他明显不良反应。观察组和对照组手术时间和术中出血量比较差异有显著性（t=9 0.99、9 1.02,P〈0.05）;两组术后盆腔淋巴结转移、脉管浸润、宫旁浸润及阴道切缘受累方面比较差异均有显著性（V2=5.037、7.246,P〈0.05）;观察组5年生存率及2、5年复发率与对照组比较,差异有显著性（V2=4 5.85～7.246,P〈0.05）。结论 PB介入化疗方案有效、低毒,对ⅠB～ⅡB期宫颈癌具有较好的疗效。PB方案是值得推广的介入化疗方案。

APPLICATION OF CISPLATIN COMBINED WITH BLEOMYCIN IN INTERVENTION CHEMOTHERAPY FOR CERVICAL CANCER

Objective To assess the effects of cisplatin combined with bleomycin（PB）in intervention chemotherapy for cervical cancer. Methods Using PB program,64patients with stageⅠB-ⅡB cervical cancer were given preoperative bilateral uterine-artery chemoembolization,the volume changes of the cervix neoplasms,before and after chemotherapy,and post-chemotherapeutic response were observed,the efficacy of the therapy was assessed as well.The patients（control group,surgery after chemotherapy）were compared with those surgery without chemotherapy（control group）with regard to intraoperative conditions and the pathology of excisional tissues to evaluate the short-term efficacy of chemotherapy.A long-term follow-up was done for long-term outcome. Results The effective and remission rates in patients of the control group were 87.5%and 96.9%,respectively,34.4% of them presented pyrogenetic reaction,no other untoward reactions were noted.There were significant differences between the observation and control groups in terms of operation time and intraoperative blood loss（t=9.099,9.102;P0.05）; the post-operative lymph-node metastases of pelvic cavity,infiltration of blood vessels and parametrium,as well as vaginal cutting edge involvement（χ2=5.037,7.246;P0.05）;and the 5-year survival rate,2-and 5-year recurrence（χ2=4.585-7.246,P 0.05）. Conclusion PB chemotherapy program is effective and hypotoxic for stageⅠB-ⅡB cervical cancer,which is worth popularization.