摘要
（目的）通过术前尺动脉插管化疗，使肿瘤缩小，降低肿瘤分期，使原来难以手术的病例获得手术根治或姑息切除。（方法）患者行尺动脉插管后，分别采用CMF、CAF或PAF三种化疗方案行动脉灌注化疗1～2周期。（结果）本组89例，其中Ⅲ期61例（Ⅲa期19例，Ⅲb期42例），Ⅳ期28例，多数患者于化疗后4～5天开始出现肿瘤退缩变软，3～4周后肿瘤缩小明显。局部有效率达95．5％，3年生存率：Ⅲa期83．3％，Ⅲb期74．2％，Ⅳ期42．9％，5年生存率分别为53．3％、35．4％、19．5％。（结论）术前区域动脉灌注化疗由于肿瘤内药物浓度高，可以有效杀灭癌细胞，缩小病灶，降低肿瘤分期，为手术争取机会，且尺动脉插管化疗还具有操作简单，给药方便，疗效确切，费用低廉，不增加手术后并发症等优点。
[Purpose] To evaluate the clinic response and survival rates of preoperative arterial chemotherapy in locally ad-vanced breast cancer patients. [Method] Eighty-nine cases with stage Ⅲa (19), Ⅲb(42) or Ⅳ (28) disease were treated by trans-ul-nar artery catheterization with 1 ~2 cycles of CMF, CAF or PAF combination chemetherapy preoperatively. [Results] The overallresponse rate was 95. 5%. The 3-yr and 5-yr surival rates of the patients with stage Ⅲa,Ⅲb and Ⅳ were 83. 3%, 74. 2% and 42.9% ； 53. 3%, 35. 4% and 19. 5 %, respectively. [Conclusion]The data of this study suggest that preoperative arteriaI chernothera-py is a more effective approch, which can reduce tumor phase (down staging), increase operability and improve long-term sur-vival. The toxicity and cost of this regimen are less than that of systedric chemotherapy.
