淋巴管灌注化疗治疗妇科癌症淋巴结转移的疗效观察

Efficacy of Endolymphatic Infusion Chemotherapy for Treatment of Gynecologic Cancers With Lymphatic Metastases

【目的】比较淋巴管灌注化疗（ 实验组）与常规放疗或化疗（ 对照组） 治疗妇科癌 症淋巴结转移的临床疗效。【方法】２０ 例患者经足背淋巴管大剂量一次性灌注给药； 灌注前后根据患者病种测定 Ｓ Ａ 或 Ｃ Ａ１２５ 的水平和顺铂的血药浓度及淋巴结转移灶影 像学变化； 并比较常规放化疗方法， 其患者 的近期疗效和２ ．５ 年生存率。【结果】实验组与对照组近期总缓解率分别为５ ５ ％ 和２０ ％ ，２ ．５ 年生存率分别为２０ ％ 和０ ， 其差异有显著性（ Ｐ ＜ ０ ．０５） ；实验组 Ｓ Ａ 或 Ｃ Ａ１２５ 测定值下降，顺铂在体内维持时间 较长。【结论】采用足背淋巴管灌注化疗，有可能成 为治疗妇科癌症淋巴结转移有效、且副作用少的新方法。

Objective To compare the clinical efficacy of endolymphatic infusion chemotherapy (testing group) with that of routine chemotherapy or radiotherapy (control group) for treatment of gynecologic cancers with lymphatic metastases. Methods Twenty patients accepted a moderately high single dose of endolymphatic infusion chemotherapy via pedal lymphatic vessels;at same period 20 other patients accepted routine chemotherapy or radiotherapy.Serum SA(sialic acid) or carbohydrate antigen 125 (CA 125) levels and blood cisplatin concentrations were estimated and foci of metastatic lymph nodes were detected by graph examination at admission and after treatment;recent efficacy and survival rates within 2.5 years were determined. Results recent remission rates of testing group and control group were 50% and 20%;and survival rates of 2.5 years were 20% and 0 respectively.The difference between two groups was significant (P<0.05).In testing group,serum SA or CA 125 levels reduced and cisplatin was maintained in body for a longer period. Conclusions Endolymphatic infusion chemotherapy via pedal lymphatic vessels may be an effective new method of treating gynecologic cancers with lymphatic metastases,bringing about little side effect.