子宫内膜癌术中区域性动脉灌注化疗的疗效观察

Effect of intraoperative local arterial infusion chemotherapy for endometrial carcinoma

目的 探讨术中区域性动脉灌注化疗对子宫内膜癌的治疗效果。方法 回顾性分析我院 2 0 0 0年 1月～ 2 0 0 2年 11月间在我科施行了术中动脉灌注化疗的 2 0例子宫内膜癌患者 (灌注组 ) ,选择同期手术治疗的子宫内膜癌患者 33例为对照 (对照组 ) ,分析两组的复发及死亡情况。结果 灌注组中Ⅰ期 8例 ,Ⅱ期 8例 ,Ⅲ期 4例 ,Ⅳ 0例 ,其中 1例ⅢaG2者于术后 8个月盆腔复发 ,无 1例死亡 ,复发率为 5 0 %。对照组中Ⅰ期 2 5例 ,Ⅱ期 3例 ,Ⅲ期 4例 ,Ⅳ 1例 ,其中 3例复发 ,复发率为 9 1%。复发者分别为ⅠbG2 - 3,ⅠcG3和ⅢcG3,1例为阴道断端复发 ,1例为盆腔复发 ,1例为远处脏器转移 ,其中 2例死亡 ,死亡率为 6 1%。两组的平均随访时间为 15 6± 5 2 (个月 )及 16 8± 7 4 (个月 ) ,差异无显著性 (P >0 0 5 )。结论 术中髂内动脉灌注化疗可降低子宫内膜癌的复发率 ,且操作简单易于掌握 ,既具有术前选择性动脉灌注化疗的优点又可避免其弊端 ,值得临床推广。

Objective To evaluate treatment the effect of intraoperative local arterial infusion chemotherapy for endometrial carcinoma.Methods A retrospective analysis was investigated on 20 patients with endometrial carcinoma who underwent intraoperative local arterial infusion chemotherapy in our hospital during a period of January, 2000 to November, 2002 (infusion group), and 33 patients with endometrial carcinoma surgical treatment in the same period (control group). The recurrence and mortality of the two groups were compared.Results In infusion group, there were 4 cases of stage Ⅰ, 8 stage Ⅱ, 4 stage Ⅲ and 0 stage Ⅳ. A pelvic recurrence of Ⅲa G2 was observed after eight months of surgery, no one died. The recurrent rate was 5 0% and the death rate was 0. In control group, there were 25 cases of stage Ⅰ, 3 stage Ⅱ, 4 stage Ⅲ and 1 stage Ⅳ. Among them, 3 relapse cases occurred at vaginal edge, pelvic and distant organ respectively, and 2 each ofⅠb G2-3, Ⅰc G3 and Ⅲc G3 died. The recurrence was 9 1% and the death rate was 6 1%. The follow-up time of the infusion and control groups was of no statistical significance [(15 6 months±5 2) and (16 8 months±7 4), P> 0 05, t [KG-3]-test]. . Conclusions intraoperative local arterial infusion chemotherapy can decrease the recurrence and mortality of endometrial carcinoma. Such a therapy is easy to perform, reaches the treatment effect of the pre-operational adjuvant intra-arterial chemotherapy and posses the advantages of avoiding separate surgical operation, worth of being applied to routine clinical practice.