动脉内灌注化疗在局部晚期宫颈癌同步放化疗中的应用

目的：探讨动脉内灌注化疗在局部晚期宫颈癌(Ⅰb2~Ⅳa 期)同步放化疗中应用的可行性及临床疗效。方法42例有详细临床病理资料的局部晚期宫颈癌患者行应用动脉内灌注化疗的同步放化疗。评估患者临床疗效,统计不良反应及生存时间,并与60例单纯行放疗患者对照比较。结果应用动脉内灌注化疗的同步放化疗总有效率为92.8%,其中完全缓解24例(57.1%)；患者5年生存率较对照组明显提高(76.2% vs 49.3%,P =0.01)。多因素 COX 风险比例模型分析显示,临床分期(P =0.016)和淋巴转移(P =0.007)是影响应用动脉内灌注化疗的同步放化疗患者预后的独立因素。结论动脉内灌注化疗在局部晚期宫颈癌同步放化疗中应用安全有效,临床分期和淋巴转移是影响预后的重要因素。

Application of intra-arterial infusion chemotherapy in concurrent chemoradiation therapy of local advanced cervical cancer

Objective To investigate the feasibility and clinical efficacy of intra-arterial infusion chemotherapy within concurrent chemoradiation therapy (CCRT)for local advanced cervical cancer (LACC:Stage Ⅰb2 - Ⅳa).Methods 42 LACC patients were treated with CCRT combining with intra-arterial infusion chemotherapy (CCRT group),and another 60 LACC patients were under-went radiotherapy alone (control group).The clinical efficacy,adverse reactions and overall survivals (OAS)were evaluated,be-tween the two groups,respectively.Results Overall response rate was 92.8% in CCRT group.Of 42 patients,24 had achieved complete response (CR)in CCRT group (57.1%).The 5-year overall survival rate in CCRT group was 76.2%,which was signifi-cantly higher than that of control group (49.3%),respectively (P =0.01).Multivariate COX proportional hazards model revealed that the clinical stage(P =0.01 6),pelvic positive lymph nodes (P =0.007)were independent factors of monitoring prognosis of LACC patients treated with CCRT combining with intra-arterial infusion chemotherapy.Conclusion CCRT with intra-arterial infu-sion chemotherapy is a safe and effective method for LCCA,and clinical stage and pelvic positive lymph node were independent fac-tors of the prognosis of patients.