中晚期宫颈癌手术前动脉灌注化疗栓塞的探讨

目的探讨中晚期宫颈癌术前动脉灌注化疗栓塞的临床价值。方法选择2005年6月2009年12月35例经阴道镜活检确诊为宫颈癌临床分期Ⅱa～Ⅲb期宫颈癌患者,术前行1次子宫动脉化疗栓塞,化疗药物为博莱霉素（BLM）＋顺铂（DDP）＋环磷酰胺（CTX）,栓塞剂为超液化碘油加明胶海绵颗粒。介入治疗后14～20d行子宫全切加淋巴结清扫术。观察动脉灌注化疗栓塞前后肿块的大小变化、术中肿块粘连状况及出血量的多少。结果经介入治疗后肿块缩小32例：完全缓解（CR）3例、部分缓解（PR）29例,肿块无变化（NC）2例,进展（PD）1例,治疗有效率为91.4%。31例选择了手术治疗,手术率为88.6%。术中肿块粘连状况：无粘连24例,轻度粘连6例,中度粘连1例。术中出血量：≤100mL7例,100～200mL18例,200～400mL6例。结论中晚期宫颈癌术前动脉灌注化疗栓塞能有效地提高肿瘤切除率,降低手术风险。

Clinical Value of Preoperative Transarterial Chemoembolization for Advanced Cervical Cancer

Objective To evaluate the clinical value of preoperative transarterial chemoembolization for advanced cervical cancer.Methods A total of 35patients with pathologically proved cervical cancer（from stageⅡa toⅢb） from June 2005to December 2009received preoperative transarterial chemoembolization once.Bleomycin,cisplantin and cytoxan were infused via bilateral uterine arteries,followed by arterial emboliezation with super-liquefaction iodipin and gel foam particles as embolic agent.Radical surgery was performed on the patients after 14-20days.Volume change of mass,accretion state and haemorrhagia amount during the operation were analyzed.Results The masses deflated in 32cases：complete response（CR）in 3,and partial response（PR）in 29.No change（NC）was seen in 3 cases.The effective rate was 91.4%.In 31cases who underwent the operation,the operability was 88.6%,in whom non-accretionin was in 24,light accretion was in 6and medium accretion was in 1.Haemorrhagia amount was less than 100mL in 11cases,100-200mL in 21cases,and 200-1 400mL in 3cases.Conclusion Preoperative chemoembolization can elevate exairesis rate and depress the operative risk effectively.