中晚期宫颈癌动脉化疗的疗效及影响因素分析

Effect of Transarterial Chemotherapy for Patients with Metaphase or Advanced Cervical Carcinoma and the Influencing Factors

目的观察PVM方案(长春新碱、卡铂、丝裂霉素)超选择性子宫动脉化疗栓塞治疗中晚期宫颈癌的疗效,评价影响化疗效果的因素。方法对25例中晚期宫颈癌患者(Ⅱb期～Ⅳa期)行动脉化疗栓塞,观察其近期疗效、副作用及影响化疗效果的因素。结果动脉化疗栓塞的总体缓解率为80.0%,先期化疗的总体缓解率为90.9%,肿瘤分期对化疗缓解率的影响有统计学意义(P=0.03);肿瘤分化程度对化疗缓解率的影响无统计学意义(P=0.32);肿瘤分期与肿瘤大小的交互作用对化疗缓解率的影响有统计学意义(P=0.03)。结论PVM方案超选择性动脉化疗的临床总缓解率高,副作用小,对宫颈鳞癌及腺癌均有效。肿瘤分期对化疗缓解率有影响,肿瘤分化程度对化疗缓解率无影响,肿瘤大小可通过影响肿瘤分期来影响化疗缓解率。

Objective To study the curative effect and related factors of the treatment for metaphase or advanced cervical carcinoma with chemoembolization of uterine arteries by a combination of carboplatin, vincristin and mitomycin （PVM regime）. Methods Totally 25 patients with metaphase or advanced cervical carcinoma （ Ⅱ b～Ⅳa ） were enrolled in this study, Treatment was consisted of PVM regime transarterial infusion of bilateral uterine arteries, then transcatheter arterial embolization. The short term effect and toxicity of transarterial chemoembolization, as well as the influencing factors were observed. Results The total rate of overall clinical response on transarterial chemoembolization was 80% ; and the rate of overall response on neoadjuvant chemotherapy was 90. 9%. The response to chemotherapy related to clinical stages was of statistically significant （ P = 0, 03 ） , but to grade of differentiation was of not （ P = 0, 32）. There was statistically significant interaction between clinical stages and tumor volume （ P = 0. 03 ）. Conclusion PVM regime yields a high response rate with acceptable toxicity. The response to chemotherapy relates to clinical stages, but not to grade of differentiation. Tumor volume affects the response to chemotherapy through the influence of the clinical stages.