术前介入化疗治疗宫颈癌56例疗效分析

目的:探讨宫颈癌术前介入化疗的近期疗效。方法:对56例宫颈癌患者实施术前介入化疗,抗癌药物选择顺铂、丝裂霉素、阿霉素或表阿霉素;部分病例在灌注化疗(2/3量抗癌药物)后用携带有抗癌药物(1/3量)的明胶海绵颗粒栓塞肿瘤供血动脉,观察近期临床及组织学疗效及不良反应,并对有手术指征者及时实行宫颈癌根治术。结果:56例介入化疗患者临床症状缓解率为100%,肿瘤消退情况8例完全缓解(CR),35例部分缓解(PR),13例无变化(NC),无疾病进展(PD),总有效率为76%,与化疗前相比肿瘤体积显著缩小(P<0.05)。56例标本严格按规定进行组织学评定,组织学有效率为82.1%(46/56),组织学完全缓解率为10.7%(6/56)。51例患者介入化疗后顺利完成根治手术,手术切除率达91%。仅有5例中、晚期宫颈癌病人无法手术,改用放疗。结论:宫颈癌术前介入化疗可以改善临床症状,缩减肿瘤体积和范围,降低肿瘤分期、提高手术切除率及减少术中出血,是一种安全、有效的局部治疗方法。

Efficiency of intra arterial neoadjuvant chemotherapy before radical resection in 56 patients with cervical cancer

Objective: To study the response to intra-arterial neoadjuvant chemotherapy in patients with cervical cancer. Methods: Fifty-six cases of cervical cancer were performed intra-arterial neoadjuvant chemotherapy with DDP,MMC,EPI or ADM. Some of them were performed the arterial chemoembolization with gelfoam particles mixed with 1/3 total drug dose after 2/3 total drug dose perfusion though the bilateral feeding arteries. The clinical response and histopathological effects of the intra-arterial neoadjuvant chemotherapy was observed,then radical resection was performed in those who were suitable for the operation. Results:After intra-arterial neoadjuvant chemotherapy,clinical symptoms remission rate was 100%,complete response (CR) was acquired in 8 patients and partial response (PR) in 35 patients.The total response rate was 76%, with no change(NC) in 13 and progressed disease(PD) in 0 of 56 cases after intra-arterial neoadjuvant chemotherapy.The tumor size reduced significantly (P<0.05), 56 specimens were histologically evaluated. The overall histological response rate was 82.1% and the complete response rate was 10.7%.After neoadjuvant therapy and the radical resection was preformed successfully in 51 patients,radical resection rate reached 91%,only 5 patients of advanced disease failed to radical resection and received radiotherapy. Conclusion: Intra-arterial neoadjuvant chemotherapy is a safe and effective therapeutic option which could alleviate clinical symptoms,to decrease tumor size,to down-staging and to increase the radical resection rate.