动脉化疗在妇科恶性肿瘤多途径化疗中的价值探讨

The Evaluation of Intraarterial Chemotherapy in Various Chemotherapy for Gynecologic Malignancy

目的：通过4种化疗方法的分析比较，了解动脉化疗在妇科恶性肿瘤化疗中的价值。材料与方法：40例妇科恶性肿瘤分成两组（卵巢肿瘤组和子宫肿瘤组），按4种不同途径行反复多次化疗，包括42次单一静脉化疗，124次静脉加腹腔化疗，106次单一动脉化疗，48次动脉化疗后再行静脉加腹腔联合化疗。结果：对卵巢恶性肿瘤采用多途径联合用药化疗近期疗效最佳（P＜0.01），单一动脉化疗与静脉加腹腔联合化疗比较无差异（P＞0.05）；对子宫恶性肿瘤采用单一动脉化疗及多途径联合化疗均较其他化疗方式近期疗效显著（P＜0.01），单一静脉化疗在二类肿瘤中疗效最差（P＜0.01）。结论：动脉化疗结合静脉和腹腔联合化疗可以提高妇科恶性肿瘤的近期疗效，对卵巢恶性肿瘤尤其重要，但单一动脉化疗对卵巢恶性肿瘤无特异性，而对子宫恶性肿瘤有价值。

Objective: To evaluate the intrarterial chemotherapy of four Protocols in the treating of gynecologic malignancy. Materials andMethods:Forty Patients with gynecologic malignancy were divided into two groups, one with ovarian tumor and the other with uterine tumor. The pa-tients repeatedly received chemotherapy via four different way, including totally 42 intravenous chemotherapy, 124 combined intravenous and in-traperitoneal chemotherapy, 106 intraarterial chemotherapy and 48 intraarterial chemotherapy followed by combining intravenous and intraperitonealchemotherapy. Results:Combination of chemotherapy through various ways demonstrated the best short-term effectiveness for patients with ovarianmalignancy (P< 0. 01 ), while no significant difference was found between simple intraarterial chemotherapy and intraperitoneal chemotherapy (P>0. 05 ). The short-term effect of intraarterial chemotherapy or combined multi-way chemotherapy was better that of other kind of simple chemotherapyfor uterine malignancy (P< 0. 01 ). The simple intravenous chemotherapy carried worst effectiveness for tumors of both groups (P< 0. 01 ). Con-clusion: Combination of intraarterial, intravenous and intraperitoneal chemotherapy can raise the short-term effect for patients with gynecologic malig-nancy, especially with ovarian malignancy. Single intraarterial chemotherapy is effetive for the treatment of uterine malignancy, though has no par-ticular value for ovarian tumors.