妇科恶性肿瘤介入治疗的疗效评价

Efficacy of Intraarterial Chemotherapy in Treatment of Gynecologic Carcinoma

目的:探讨介入化疗在妇科恶性肿瘤中的应用价值。方法:46例妇科恶性肿瘤(宫颈癌39例、卵巢癌3例、肠癌术后盆腔转移 2例、多原发癌1例、阴道癌1例)行介入治疗,观察与评价其临床疗效、毒副反应、生存情况。结果:介入治疗后,30例有效,总有效率 65．2％,宫颈癌有效率74．4％;23例分别行宫颈癌根治术、卵巢癌肿瘤细胞减灭术;无严重并发症;30例有效患者中死亡3例,复发2 例,1例失访,存活时间最长为49个月。结论:介入治疗对妇科恶性肿瘤具有一定疗效,尤其对宫颈癌效果良好,但对有深肌层浸润、盆淋巴结转移肿瘤是否有显著优越性及能否提高远期疗效,需进一步探讨;晚期卵巢癌如同时结合静脉化疗,可提高疗效。

Objective： To study the clinical value of the intraarterial chemotherapy in gynecologic carcinoma. Methods： 46 cases of gynecologic carcinoma 39 cases of cervical cancer , 3 cases of ovarian cancer, 2 cases of pelvic metastases after intestinal carcinoma operation , 1 case of multiple primary carcinoma, 1case of vaginal cancer ） were included in the study. The efficacy, toxicity and survival time were evaluated. Results.. After Intraarterial chemotherapy, the total efficacy rate was 65.2%, the rate in cervical cancer was 74. 4%. 23 cases were respectively underwent radical hysterectomy plus bilateral salpingo-oophorectomy and pelvic lymphadenectomy, cyto-reductive operation. No serious complication occurred. In 30 effective cases, 3 died ,2 relapsed, 1 lost follow up, the longest survival time was 49 months. Conclusion：Intraarterial chemotherapy is certainly efficacious in gynecologic carcinoma, especially in cervical cancer. But more studies are needed on the efficacy of the carcinoma with deep muscle involved or positive pelvic lymph nodes. More efficacious will be made in the advanced ovarian cancer combining with intravenous chemotherapy.