超选择性动脉插管持续灌注化疗治疗绒癌耐药患者的分析

SelectiveArterialCatheterizationintheManagementofDrug┐ResistantChoriocarcinoma

目的：探讨超选择性动脉插管持续灌注化疗治疗绒癌耐药患者的疗效。方法：７１例患者均接受全身化疗和选择性动脉插管持续灌注化疗。其中５例为并发癌灶破裂大出血者，先予动脉插管栓塞止血；１３例为肺脏有病灶者，加用了支气管动脉灌注化疗。结果：７１例中，５５例获完全缓解，１０例为部分缓解，１例自动出院并失随访，５例死亡。存活的６５例中，１２例已超过５年，其中２例已足月分娩。结论：超选择性动脉插管持续灌注化疗联合全身静脉化疗，对绒癌耐药患者有效。对并发癌灶大出血者，动脉插管栓塞是有效的应急止血措施。

Objective:Inordertosavethelifeofthepatientswithdrug-resistantchoriocarcinomaduetoimpropertreatment,selectivearterialcatheterizationwasused.Methods:Althe71casesweretreatedwithsystemicchemotherapytogetherwithpelvicselectivearterialchemotherapy.5ofthemhadarterialchemotherapyplusarterialembolizationforhemorrhage.In13patientswhohadlungmetastasis,intraarterialinjectionofmethotraxate(MTX)throughbronchialarterialwasadded.Results:55of71(77.8%)achievedcompleteremissionand10(14.1%)hadpartialremission.Onepatientfailedtofolow-up.5diedofvariouscausesduringhospitalization.OnFolow-up12hadsurvivedformorethan5yearswithnosignsofrecurrence.2ofthemhadchildbirthafterrecovery.Conclusion:Systemicintravenousinfusionchemotherapyincombinationwitharterialchemotherapyisusefulfordrug-resistantchoriocarcinoma.Inpatientswithintraperitonalhemorrhagecausedbytumorrupture,selectivearterialembolizationshouldbeusedasemergencytreatmenttoefectivelycontrolthebleeding,inorderthatpatientswilhaveachanceforfurtherchemotherapy.