表柔比星、顺铂介入治疗妇科中晚期恶性肿瘤

Epirubicin and cisplatin of interventional treatment for gynecological advanced malignant tumors

研究表柔比星 (epirubicin ,EPI)、顺铂 (csiplatin ,DDP)介入治疗妇科中晚期恶性肿瘤的应用方法及疗效。方法 :44例患者 ,其中宫颈癌 2 9例 ,卵巢癌 1 5例。宫颈癌巨瘤型瘤体直径 4— 6cm ,平均直径 4 8cm。按FIGO分期 :Ⅱa5例 ,Ⅱb1 2例 ,Ⅲa9例 ,Ⅲb2例 ,Ⅳ 3例 ,鳞状上皮癌 2 6例 ,腺癌 3例 ,卵巢癌Ⅱc2例 ,Ⅲ 1 0例 ,Ⅳ 3例 ,(复发癌 2例 ) ,上皮性癌 1 2例 ,转移性低分化腺癌 ,均以病理切片证实。用EPI DDP介入治疗 74人次 ,同时行髂内动脉栓塞 8例 ,子宫动脉栓塞 2 0例 ,进行疗效评定 ,观察其手术切除率 ,近其疗效及毒副反应。结果 :2 5例宫颈癌及 7例卵巢癌行根治术 ;3例卵巢癌仅能行子宫次切除 ,双侧附件切除、阑尾及大网膜切除 ;2例双侧附件切除。症状缓解率 95 4% ( 42 44) ,肿块消退有效率 77 2 % ,手术切除率 84 1 % ( 37 44)。随访 42例 ,失访 2例 ,健在 39例 ,存活期 6— 31月 ,平均 2 4 5月。结论 :EPI DDP介入治疗妇科中晚期恶性肿瘤疗效显著 ,是当前一种增加手术切除率、提高生存率、而毒副反应轻的较理想方法之一。

Purpose:To study the curative effect of epirubicin (EPI) and cisplatin diaminodichloride (DDP) as well as the method of interventional treatment for gyneocological advanced malignant tumors.Methods:44 cases were included, among them 29 cases were cervical cancers of large masses, the diameters being 4—6 cm,average 4.8 cm;15 cases were ovarian cancer. According to the FIGO staging, there were 5 cases in stage Ⅱa,12 cases in stage Ⅱb, 9 cases in Ⅲa, 2 cases, in stage Ⅲb,1 case in stage Ⅳ;26 cases were squamous epithelial cancers ,3 cases were cervical adenocarcinomas. 2 cases in stage Ⅱc, 10 cases in stage Ⅲ, 3 cases in stage Ⅳ(2 cases were recurrent cancers);12 cases were squamous epithelial cancer, 3 cases were transitional lowly differentiated adeno carcinomas in ovarian cancers, they were all proved by pathological diagnosis.The 44 cases were treated 74 times by interventional method with EPI and DDP,8 cases were given internal iliac artery embolism, 20 cases were given uterine artery embolism at the same time. Curative effect, operative rate, effect in the near future and side effect were observed.Results:25 cases of cervical carcinoma and 7 cases of ovarian carcinoma were given radical operation, 3 cases of ovarian cancers were only given subtotal hysterectomy, biateral annex, appendix and omentum magus were excised. 2 cases were only received annex section. Symptom relief rate was 95.4% (42/44), disappearance rate of mass was 77.2%,operation rate was 84.1%(37/44). 42 cases were followed up, 2 cases were lost, 39 patients survived for 6—31 months, average 24.5 months.Conclusions:The effect of interventional treatment with EPI and DDP is marked. It can increase operation rate, prolong life, while the side effect is mild. It is an ideal method of treatment of advanced gynecological malignant tumors. But after intervention therapy and operation of ovarian cancers, we must give patients chemical therapy by several ways.