Ⅲ期乳腺癌术前介入化疗栓塞的临床观察

Clinical effect of preoperative intra-arterial chemotherapy and embolization in breast cancer patients of stage Ⅲ

目的探讨Ⅲ期乳腺癌术前动脉化疗栓塞的近期临床疗效。方法采用Seldinger技术将导管插至肿瘤血管内,灌注顺铂(DDP)60～80mg、吡柔比星(THP)50～60mg、氟脲嘧啶脱氧核苷(FuDR)1000～1250mg药物和适量明胶海绵栓塞治疗16例Ⅲ期乳腺癌病人,2～8周后行根治手术,术后给予化疗和放疗或内分泌治疗。结果16例Ⅲ期乳腺癌采用介入化疗栓塞后,肿块和转移淋巴结均有明显缩小;根治术后随访2～5年,13例无癌生存期达5年以上,与同期未作介入治疗者相比,手术时间缩短和术中出血量减少[(88.7500±8.5674)ml,(102.5200±13.799)ml,t=3.5667,P<0.05;(1.7563±0.1580)h,(2.0280±0.1568)h,t=5.3967,P<0.05],创口种植、伤口感染、皮瓣坏死等手术并发症未见增加(P>0.05)。结论Ⅲ期乳腺癌术前介入化疗栓塞疗效明显,增加手术切除机会,减少术中出血和缩短手术时间。

Objective To investigate the clinical effect of prenperative intraarteial chemotherapy and embolization in breast cancer patients of stage m Methods Seldinger procedure was used to cathetered to the vascular of tumors, intra - arterial chemotherapy with DDP 60 - 80mg, THP 50 - 60mg, FuDR 1000 - 1250mg and embolization with gelatin sponge particle were given to 16 cases breast cancer patients of stage Ⅲ, operation was carried out after 2 - 8 weeks, and chemtherapy radiotherapy or endocrinetherapy was given after operation. Result The primary tumor loci and the metastatic LN in 16 cases breast cancer patients of stage Ⅲ all reduced after the interventional therapy. All patients underwent radical mastectomy afterwards and were followed - up for 2 - 5 years with 13 still alive without cancer for more than 5 years, the operation implication such as implantation or infection of incisions, necrosis of skin flap was similar to those not receiving preoperative intervensive chemotherapy and embolization （ P 〈 0.05 ）, Blood loss and operative time were significantly decreased in the preoperation chemo- embolization group as compared with not receiving preoperative interveusive chemotherapy and enbolization group（88. 7500 ± 8.5674ml, 102. 5200 ± 13. 799ml, t = 3. 5667, P 〈 0.05 ; 1. 7563 ± 0. 1580h, 2. 0280 ± 0. 1568h, t = 5. 3967, P 〈 0.05）. Conclusion Preoperative intra - arterial chemotherapy and embolization is an available and effective methed to treat breast cancer patients of stage Ⅲ, it can increase the chance of radical resection, also it can reduce blood loss and decrease operative time.