经股动脉植入微型导管药盒系统灌注化疗治疗28例盆腔恶性肿瘤

Perfusion chemotherapy through implanted mini port-catheter system via femoral artery in 28 cases of pelvic malignancy

目的探讨经股动脉植入防返流微型导管药盒系统(PCS)灌注化疗治疗盆腔恶性肿瘤的疗效。方法 28例盆腔恶性肿瘤患者先行双侧髂内动脉前干化疗栓塞,然后髂内动脉前干的非主要供血侧用明胶海绵颗粒和弹簧圈栓塞,其主要供血侧仅用明胶海绵颗粒作适量栓塞,经股动脉植入防返流微型PCS,导管留置于主要供血侧髂内动脉前干,术后定期经微型PCS行灌注化疗。结果 28例患者均成功植入微型PCS。27例患者切口愈合良好,1例患者切口延迟愈合。微型PCS灌注化疗1个疗程后,完全缓解8例,部分缓解16例,疾病稳定2例,疾病进展2例,总有效(完全缓解及部分缓解)24例(85.7%)。不良反应轻微,无严重并发症发生。随访3～18个月,死亡1例,存活27例。结论经股动脉植入防返流微型PCS灌注化疗治疗盆腔恶性肿瘤的疗效满意,不良反应及并发症少,操作简便、值得临床推广。

Objective To explore the efficacy of perfusion chemotherapy in pelvic malignancy through implantation of anti-reflux and mini port-catheter system（PCS） via femoral artery.Methods 28 patients with pelvic malignancy were previously subjected to chemoembolization in anterior divisions of bilateral internal iliac artery,and then the side of non-primary blood supply of anterior division of internal iliac artery was embolized using gelatin sponge particles and spring coil,while the side which was primary blood supply was embolized appropriately with only gelatin sponge particles.The anti-reflux and mini PCS was implanted via femoral artery,and the catheter was placed in the anterior division of internal iliac artery which was primary blood supply.Perfusion chemotherapy was performed regularly with mini PCS after operation.Results Mini PCS were successfully implanted in 28 patients,with 27 cases of well incision healing and 1 case of delayed incision healing.After one course of perfusion chemotherapy through mini PCS,it was found that 8 cases of complete remission,16 cases of partial remission,2 cases of stable disease,2 cases of progressive disease and 24 cases（85.7%） of total effective remission（complete and partial remission）,with mild adverse reaction and no serious complication occurring.3 to 18 months of follow-up showed 1 death and 27 survivals.Conclusion Perfusion chemotherapy in pelvic malignancy through implantation of anti-reflux and mini PCS via femoral artery has satisfactory therapeutic efficacy,with less adverse reaction and complication,simple operation and is worth clinical promotion.