卵巢癌术后复发介入化疗疗效分析(附18例临床报告)

Analysis of effect of the interventional treatment for the postoperantive recurrent ovarian carcinoma: report of eighteen cases

目的：总结１８例卵巢癌术后复发患者经介入动脉插管化疗的疗效，并对栓塞剂的应用进行了初步探讨。材料和方法：采用经皮股动脉穿刺双侧髂内动脉选择性插管的方法进行化疗灌注和栓塞。化疗方案为卡铂＋表阿霉素（简称：ＣＡ方案），３例在ＣＡ方案的基础上加用足叶乙甙（ＶＰ－１６），５例同时进行髂内动脉栓塞，所用栓塞材料包括明胶海绵碎块（２例）、顺铂微球（２例）、碘化油（１例）。结果：在１５例可评价疗效的病例中，ＣＲ１例，ＰＲ６例，ＭＲ５例，ＳＤ２例，ＰＤ１例，有效率ＣＲ＋ＰＲ为４６．６％（７／１５）。结论：动脉插管化疗是卵巢癌术后复发较合理的辅助疗法；卡铂＋表阿霉素化疗方案对卵巢癌术后复发有较好疗效；进行髂内动脉栓塞化疗时选用明胶海绵碎块作栓塞剂，副作用较少。

Objective: To investigate the role of the interventional treatment for the postoperative recurrent ovarian carcinoma, the results in 18 cases were analysed, and rational application of the embolic materials in the treatment was discussed. Methods: The infusion chemotherapy and embolization of the bilateral internal iliac artery were performed using the Seldinger technique via the percutaneous femoral arterial catheterization. Chemotheraputic regimen was consisted of Carboplatin and (Epirubicin, EADR). Except for Carboplatin and EADR, Vp-16 was also administrated in 3 cases. The intra-arterial embolization in 5 cases was carried out with gelfoam fragment (2 cases), DDP-microspheres (2 cases) and lipiodol (1 cases). Results: The response rate (CR+PR) was 46.6% (7/15) with CR 1, PR 6 in 15 evaluable patinets. Conclusions: The results indicate the infusion chemotherapy and embolization of the internal iliac artery was a relatively good treatment modality for the postoperative recurrent ovarian carcinoma. The chemotheraputic regimen of Carboplatin+EADR had good effect to the patients. The side-effect was not serious as the gelfoam fragment was used in internal iliac arterial embolization.