宫颈癌介入下新辅助联合化疗毒性反应及并发症处理的临床体会

Management of Toxicity and Complications of Interventional Chemotherapy in Cervical Cancer

目的:探讨介入化疗栓塞加放疗治疗中晚期宫颈癌的近期化疗毒性反应及并发症的预防及处理。方法:对8例中晚期宫颈癌患者采用介入超选择动脉插管化疗及栓塞,术后配合手术或放射治疗。结果:化疗反应及并发症,最常见的为消化道反应和骨髓抑制,本组8例均出现。其次为肝功能异常,梗阻性肾病,栓塞综合征等,对症治疗后都能恢复,无1例发生化疗相关死亡。结论:①严格术前介入治疗的适应证。②动脉插管应在DSA下进行,定位准确。尽量超选择性插管,使药物仅进入靶动脉,在血管有变异时灵活处理,避免损伤非肿瘤血管。③注意对介入治疗的并发症防治,尤其是栓塞综合征。介入化疗栓塞可以有效降低分期,增加了Ⅱ期手术的机会;超选择子宫动脉化疗栓塞对晚期宫颈癌是一种安全有效的治疗措施。

Objective：To study the prevention and management of the toxicity and complications of interventional chemotherapy and embolization with radiotherapy for mataphase and advanced cervical cancer. Methods：8 cases of mataphase and advanced cervical cancer performed interventional chemotherapy and embolization with radiotherapy,partly arterial chemoembolization. Results：The commonest response and complication of chemotherapy was leucopenia and gastrointestinal complication, whih occured in all 8 cases. The second ones was abnormal liver function,obstructive nephropathy and embolism syndrome. All symptoms recovered after symptomatic treatment, and no case dead from chemotherapy. Conclusion： ① The indiction of interventional therapy should be grasped strictly. ②The arterial cannula should be exactly fixed and guided by DSA. The selective cannulation can guide the drug into target artery and prevent normal vessels from injury. ③It should be accentuated to prevent and treat the complications of interventional therapy, specially embolism syndrome. The interventional chemotherapy and embolization can reduce the stage of cancer and increase the opportunity of surgery in stage Ⅱ . It was a safe and effective therapy for advanced cervical cancer.