腹壁下动脉插管化疗在宫颈癌手术前的应用

Inferior epigastric arterial cannulation (IEAC) chemotherapy to cervical cancer before operation

目的探讨宫颈癌术前行腹壁下动脉插管化疗的临床疗效、病理学改变及癌组织内的药物浓度。方法对54例宫颈癌患者实施术前腹壁下动脉插管化疗，抗癌药物选择卡铂、平阳霉素；并对9例患者检测了化疗后宫颈癌组织内铂离子的浓度。嫱果54例宫颈癌中36例（36／36）Ⅱ期、10例（10／12）Ⅲa期、3例（3／6）Ⅲb期经1～3次术前腹壁下动脉插管化疗后可顺利手术切除；术后标本病理切片中见大量坏死组织度淋巴细胞浸润。其中组织学完缓解（HCR）11例；9例检测了宫颈癌组织内的铂离子浓度，发现动脉灌注组织内的铂离子浓度明显高于静脉灌注。嫱话宫颈癌术前行腹壁下动脉插管化疗可有效提高癌组织内的抗癌药物浓度。缩小肿瘤体积，部分患者迭到了完全缓解。

Objective It is to approach the therapeutic effects, pathological changes and concentration of anticarcinogen in the tumor tissues with cervical cancer after IEAC chemotherapy before operation. Methods 54 cases of cervical cancer were performed chemotherapy by IEAC method with carboplatin and pingyangmycin before operation, Concentrations of Pt2 ＋ in the tumor tissues of 9 cases were measured after the operation, Results 49 patients （36（36/36）Ⅰ, 10（10/20）Ⅲa, 3（3/6）Ⅲb stage） were resectable after 1 to 3 times of treatment. Mass necrosis and lymphocyte cells infiltration were found in the tumor tissue. 11 cases gained histological complete recovery （HCR） clinically, The concentrations of Pt^2＋ in the tumor tissues of 9 eases through the arterial way were higher than those of intravenous chemotherapy. Conclusion The preoperative IEAC chemotherapy is proved to be effective the concentration of drugs in tumor tissue as well as in reducing tumor size. Some patients can reach HCR.