术前介入化疗在子宫内膜癌的应用及对手术的影响

目的 探讨术前持续子宫动脉灌注化疗在子宫内膜癌治疗中的应用及其对随后手术的影响。方法 在DSA下超选择与肿瘤血管染色占优势侧的子宫动脉，持续动脉滴注顺铂100mg和阿霉素50mg5d，拔管后3－4周手术。选择化疗后手术的子宫内膜癌患者20例为NAC组，随机选择同期直接手术的40例作为对照，比较术中，术后情况。结果 术前化疗组20例中完全缓解率为5．0％，总反应率为60．0％，两组患者术中出血量、手术时间、术后膀胱肠道功能恢复和创口愈合情况均无差异。NAC组浸润肌层外1／2的例数和淋巴结转移率均低于对照组（P＜0．05）。结论 术前子宫动脉化疗可缩小肿块体积，消除亚临床转移，但并不增加随后手术的并发症。

Application and influence of preoperative intervention intra-arterial chemotherapy (NAC) of uterine artery for endometrial carcinoma

Objective To analyse the effect of preoperative persistant infusion chemotherapy via uterine artery on endometrial carcinoma and followed by hysterectomy. Methods According to the Seldinger's technique, polyethylene catheter was superselected into the uterine artery. The drugs were infused with cisplatin 100mg and doxorubicin 50mg in a consecutive low dose method for five days. Radical surgery was performed about three or four weeks after NAC. The NAC group ( n =20) underwent surgery following intra arterial chemotherapy, while the control group ( n =40) was randomly selected among the patients of endo metrial carcinoma performed operations in our hospital. Results One (5.0%) patient showed complete response in NAC group, the rates of complete response plus partial response were 60.0%. There were no significant differences in bleeding amounts, the operation time, the function recovery of bladder and bowel, the healing time of the incision between the two groups. Compared with the control group, infiltration larger than half of myometrium and lymphnodes involvement were statistically significant lower in NAC group ( P <0.05). Conclusions Preperating intra arterial chemotherapy may reduce tumor volume and possiblely eradicate subclinical metastases without increasing the incidence of operative complications.