妇科恶性肿瘤淋巴结转移的腹膜后与腹腔化学治疗的比较

目的 比较妇科恶性肿瘤患者淋巴结转移的腹膜后化学治疗（化疗）和腹腔化疗的疗效,并进一步评价腹膜后化疗。方法 选择６２例妇科恶性肿瘤患者,手术前分别随机进行腹膜后化疗４３例、腹腔化疗重复给药１１例和腹腔化疗单次注药（５氟嘧啶,５－ＦＵ）８例,采用高效液相色谱侧定法（ＨＰＬＣ）检测淋巴结内－５ＦＵ的浓度。其中１６例腹膜后化疗重复给药患者,比较注药侧与未注药侧淋巴结内５－ＦＵ的浓度。选择腹膜后化疗患者６

The contrast between chemotherapy via pelvic retroperitoneal cannulation and intraperitoneal chemotherapy in gynecological malignancies cancers with lymph node metastases

OBJECTIVE: To contrast the pelvic retroperitoneal (RP) chemotherapy with intraperitoneal (i.p.) chemotherapy in gynecological malignancies with lymph node metastases. METHODS: Fluorouracil (5-FU) was repeatedly injected into the pelvic retroperitoneal space of 43 patients and the abdominal cavity of 11 patients. High performance liquid chromatography was used to determine the drug concentration of 5-FU. 5-FU was repeatedly injected into the pelvic retroperitoneal space of 16 patients via cannulation to observe the nodal 5-FU concentration of injected side and the control side. 99mTc-Sb2S3, Isovist-300 were injected into the pelvic retroperitoneal space of two groups (each one has 3 patients) respectively via cannulation. Single proton emission computer tomography (SPECT) and X-Ray film were taken to observe the allocation of the drugs. RESULTS: (1) Pelvic and periaortic nodal 5-FU concentrations of RP were 60-106 and 76-119 times of that of i.p. respectively. (2) The nodal 5-FU concentrations on repeated injection side were 16-20 times of that on control sides of RP. (3) There was no complications or adverse effect observed. (4) 5-FU was allocated to the space including the external iliac, internal iliac, obturator, deep inguinal and common iliac lymph nodes and also up to the periaortic lymph nodes. CONCLUSION: RP was more effective than i.p. for the treatment of lymphatic metastasis of gynecologic cancer.