单次大剂量顺铂(卡铂)超选择髂内动脉插管化疗用于晚期妇癌初探

A study on the treatment of advanced gynecologic cancer with chemotherapy of one-time high dose cisplatin via superseleetive internal iliac artery.

目的:研究术前应用超选择髂内动脉插管化疗对晚期妇癌的治疗作用。方法:采用Seldinger插管方法和数字减影血管造影(DSA)术,对晚期妇癌11例行14例次超选择髂内动脉插管化疗,并进行手术等后继治疗及随访观察。结果:11例中10例出现局部客观反应,CR2例,PR4例,ImPR2例,ST2例;后继手术等治疗存活0.5～1a 2例,1～3a2例,3～5a 1例,5a以上1例。1a内死亡4例,存活3a死亡1例。结论:单次大剂量顺铂超选择髂内动脉插管化疗,可使肿瘤缩小、松动,为手术等治疗创造条件,是治疗晚期妇癌一种新的有效辅助疗法。

Objective To investigate the effect of preoperative chemotherapy of SIAC for advanced gynecologic cancer. Methods All of the 11 cases withadvanced gynecologic cancer were treatedwith chemotherapy of one-time high doseeisplatin (or carboplatin ) via SIAC, DSAtechniques and subsequent operation as wellas pathologic examination. Results 10 of 11 cases achieved localobjective response which included CR 2eases, PR 4 eases, ImPR 2 cases and ST 2cases. On follow-up 6 cases had survived for0. 5～1 year and 3 cases for 3～5 years and1 case for more than 5 years. Pathologicexamination showed necrosis of cancertissue, decreased density index and divisionindex of cancer cells. Conclusions One-time high dose cisplatin chemotherapy via SIAC is an effective neoadjuvant therapy for advanced gynecologic cancer. It can reduce and slacker the tumor which results in possibility of the subsequent optimal surgery.