宫颈癌术前动脉化疗栓塞的临床应用

The Clinical Application of Cervical Cancer Preoperative Transcatheter Arterial Chemoembolization

目的研究局部进展期宫颈癌术前子宫动脉化疗栓塞的疗效及病理改变。方法对2004年8月至2011年10月在我院就诊经病理活检证实的宫颈癌35例,其中鳞癌32例,腺癌3例,FIGLOL临床分期Ⅰb2期14例,Ⅱa期5例,Ⅱb期16例。患者术前实施动脉介入化疗,抗癌药物为顺铂、阿霉素和博来霉素,灌注化疗后用明胶海绵颗粒栓塞肿瘤供血动脉。结果 35例宫颈癌患者均进行一次术前介入化疗后顺利手术切除。术后标本病理切片中可见大量坏死组织及淋巴细胞浸润。结论子宫动脉化疗栓塞用于宫颈癌术前辅助化疗安全有效,可在短期内有效控制肿瘤生长缩小肿瘤体积。减少术中出血,并可能降低临床分期,有利于肿瘤根治切除。

Objective To evaluate preoperative transarterial chemoembolization in treating locally advanced cervical cancer and to observe the pathological changes. Methods During the period of Aug.2002-Dec.2009,Thrty-five patients with pathologically proved cervical cancer were enrolled in this study. Including 14 cases of IB2,5 cases IIa and 16 cases lib. Preoperative transarterial chemoembolization was performed with cervical cancer.The antineoplastic druge included cisplatin,epirubicin and BLM.In all patients,interventional arterial infusion chemotherapy was carried out before the embolization of bilateral tumor-feeding arteries with gelfoam was made. Results Thrty-five patients underwent radical resection surgery after receiving 1 times of chemoembolization. Pathologically, massive necrosis and lymphocytic infiltration were found within the tumor. Conclusion Preoperative transarterial chemoembolization is a safe and effective adjunctive means for the treatment of cervical cancer, can effectively decrease the tumor size and reduce blood loss during operation,which is very helpful for the subsequent radical hysterectomy.