介入治疗中晚期宫颈癌24例疗效分析.doc

1 介入治疗中晚期宫颈癌 24 例疗效分析【摘要】目的观察介入治疗对中晚期宫颈癌的临床治疗效果。方法对Ⅱb 以上及手术和放疗后复发的 24例宫颈癌患者, 采用介入治疗的经皮行双髂内动脉或子宫动脉灌注化疗/ 栓塞术治疗 1~3 次,观察临床症状及肿瘤大小缓解情况。结果经介入治疗后 18 例临床症状完全缓解, 2例明显缓解, 2 例中度缓解,症状缓解率为 % 。肿瘤缓解情况, CR 3例, PR 18例, 总有效率为 % 。 17 例分期不同程度下降,其中 8 例患者降期后行手术切除。结论介入治疗对中晚期宫颈癌有一定的近期疗效,可以缓解症状、提高生活质量, 部分患者降期后重新获得手术机会, 是宫颈癌综合治疗的有效手段之一。【关键词】宫颈癌介入治动脉化疗动脉栓塞[ Abstract ] Objective To observe the efficacy of interventional therapy in patients with intermediate and advanced stage uterine cervix Twenty-four patients were staged asⅡb or above or relapsed uterine cervix 2 cancer after operation and radiotherapy was treated once to three times with arterial chemotherapy and embolotherapy by hibateral internal iliac artery and uterine artery per The overall symptomatic relief rate was %.The number of CR , PR and MR were 18,2 and 2 total effective rate of tumor was %.CR and PR were observed in3 and 18 all the 17 patients whose stages were lowed in different extent ,8 were Interventional therapy is one of the effective treatments to relief symptom , improve the quality of life and degrade the short-term effective was observed in this patients were medically operable after interventional therapy. [ Key words ] uterine cervix cancer ; interventional therapy ; arterial chemotherapy ; arterial embolism 宫颈癌是妇科常见的恶性肿瘤, 早期的宫颈癌采用手术的放射治疗均可获得较好的疗效, 对于中晚期失去手术机会或手术、放疗后复发者往往难以获得理想的治疗效果。近年来, 介入治疗的经双侧髂内动脉或子宫动脉灌注化疗栓塞术应用于中晚期宫颈癌患者,在中晚期宫颈癌的综合治疗中取 3 得了较为满意的疗效。使部分患者获得了手术机会, 生活质量得到了明显改善。现将结果报告如下。 1 资料与方法 一般资料 2005 年4 月~ 2007 年6 月,接受介入治疗的宫颈癌患者共计 24 例,年龄 32~ 72 岁,平均 岁。按国际妇产科联盟( FIGO ) 标准分期Ⅱb 14例,Ⅲb2例,Ⅳa 1 例,术后及放疗后复发者 7 例。病理类型:鳞癌 22例,鳞腺癌 1例, 腺癌 1例。合并阴道出血者 3例, 宫颈癌合并子宫肌瘤者 1例。 24 例患者中行 1 次介入治疗者 5例,2次者 16 例, 3 次者 3 例。每次介入治疗间隔 3~4 周。 方法采用 Seldinger 技术,将 5F 眼镜蛇或子宫动脉导管经一侧股动脉插入腹主动脉, 成袢后分别选插入双侧髂内动脉或子宫动脉, 先行造影了解肿瘤供血情况, 根据肿瘤血供情况决定药物灌注量以及是否进行栓塞, 主要供血侧灌注化疗药物总量 2/3 , 对侧灌注 1/3 。常用化疗药物有: 阿霉素( ADM ) 50~ 60 mg ,顺铂( DDP ) 6