髂内动脉灌注化疗与子宫动脉化疗栓塞晚期宫颈癌的临床疗效对比

Comparison of Clinical Efficacy of Intra-iliac Artery Infusion Chemotherapy and Advanced Uterine Arterial Chemoembolization in Advanced Cervical Cancer

目的探讨髂内动脉灌注化疗与子宫动脉化疗栓塞治疗晚期宫颈癌的临床疗效。方法将283例患者随机分为观察组(n=142)和对照组(n=141)。对照组给予髂内动脉灌注化疗,观察组给予子宫动脉化疗栓塞治疗。观察比较两组临床疗效、术后不良反应发生情况、术后1年生存率及复发转移情况、生活质量改善情况。结果观察组患者临床有效率(73.24%)显著高于对照组的(46.10%)(Z=-4.649,P=0.000)。两组介入治疗后,观察组发热及腹痛发生率明显高于对照组(χ~2=28.352,P=0.000;χ~2=30.789,P=0.000)。观察组1年生存率(96.48%)明显高于对照组的(90.07%)(χ~2=4.638,P=0.031);局部复发率(14.08%)低于对照组(24.82%)(χ~2=5.082,P=0.024);远处转移率未见统计学差异(χ~2=0.678,P=0.410)。观察组生活质量改善率为35.92%,明显高于对照组的(25.53%)(Z=-2.671,P=0.008)。结论子宫动脉化疗栓塞治疗晚期宫颈癌患者近期临床疗效显著,患者1年生存率升高,局部复发率降低,生活质量得以改善,但发热、腹痛等栓塞综合征较为常见。临床中,我们在选择介入治疗方案时,还应综合考虑患者临床分期,综合确定治疗方案。

Objective To investigate the clinical efficacy of internal iliac artery infusion chemotherapy combined uterine artery chemoemholization in the treatment of advanced cervical cancer. Methods 283 patients were randomly divided into the observation group （n = 142） and the control group （n = 141 ）. The control group was given intraperitoneal arterial infusion chemotherapy, and the observation group was treated with uterine arterial chemoembofization. The clinical efficacy, postoperative adverse reaction, postoperative 1-year survival rate and recurrence metastasis and quality of life improvement were observed and com- pared. Results The clinical effective rate （73.24%） in the observation group was significantly higher than the control group （46.10%） （Z = -4. 649, P = 0.000）. The incidence of fever and abdominal pain in the observation group was significantly higher than that the control group （ χ^2= 28. 352, P = 0.000 ; χ^2= 30. 789, P = 0. 000）. The 1 -year survival rate （96.48%） was significantly higher than that of the control group （ 90.07 % ） （χ^2 = 4.638,P = 0.031 ） ; the local recurrence rate （ 14.08 % ） was lower than that of the control group （24.82% P =0. 024）. There was no significant difference in distant metastasis rate （χ^2= 0. 678, P = 0. 410 ）. The improvement rate of life expectancy in the observation group was 35.92% , which was significantly higher than the control group （ 25.53 % ） （ Z = - 2.671 ,P = 0.008 ）. Condusion It has a significant clinical efficacy of uterine artery chemoembolization for advanced cervical cancer patients. It can increase the 1-year survival rate, reduce the local recurrence rate and improve the quality of life. But, the embolism syndrome including fever and abdominal pain is more common. In clinic, the patient＇s clinical stage should be considered in determining the treatment plan and the interventional therapy.