女性生殖系统恶性肿瘤超声引导下瘤内注射化疗药的疗效分析

Efficacy of ultrasound-guided intratumoral injection chemotherapy for malignant tumours of the female genital system

目的回顾性研究女性生殖系统难治性复发性恶性肿瘤超声引导下瘤内注射化疗药的疗效。方法选取2016年4月至2021年5月中国医科大学附属盛京医院收治的女性生殖系统难治性复发性恶性肿瘤病例66例,按照肿瘤病理类型将其分为子宫内膜癌组、宫颈癌组和卵巢癌组。治疗前及治疗后1个月内,观察3组肿瘤大小的变化及周围有无新病灶出现,评估疗效,记录肿瘤标志物变化,以及注射后药物不良反应。结果共纳入研究39例,子宫内膜癌组5例患者中,完全缓解0例,部分缓解4例,稳定0例,进展1例,客观有效率80.0%(4/5),获益率80.0%(4/5);宫颈癌组15例患者中,完全缓解0例,部分缓解6例,稳定6例,进展3例,客观有效率40.0%(6/15),获益率80.0%(12/15);卵巢癌组19例患者中完全缓解0例,部分缓解12例,稳定5例,进展2例,客观有效率63.2%(12/19),获益率89.5%(17/19)。3组平均客观有效率为61.1%,平均获益率为83.2%。3组客观有效率比较有统计学差异(P=0.292),疾病控制率比较无统计学差异(P=0.584)。病灶内注射化疗药后,卵巢癌患者的CA125水平下降(P=0.017),宫颈癌(P=0.673)和子宫内膜癌(P=0.117)患者则无显著变化。结论超声引导下在女性难治性复发性盆腔恶性肿瘤病灶内注射化疗药具有一定的近期治疗效果,可有效控制疾病,降低卵巢癌肿瘤标志物CA125水平。

Objective To study the efficacy of ultrasound-guided intratumoral injection of chemotherapeutic agents for refractory recurrent malignant tumors of the female genital system.Methods Sixty-six cases of refractory recurrent malignant tumors admitted to Shengjing Hospital of China Medical University from April 2016 to May 2021 were selected and divided into endometrial cancer group,cervical cancer group and ovarian cancer group according to tumor pathological types.Changes in tumor size and the appearance of new lesions around the tumors in the three groups were observed before and within 1 month after treatment to assess the efficacy,record changes in tumour markers,and adverse drug reactions after injection.Results A total of 39 patients were included in the study.Of the 5 patients in the endometrial cancer group,0 were in complete remission,4 were in partial remission,0 were stable,and 1 was progressive,with an objective efficiency rate of 80.0%(4/5)and a benefit rate of 80.0%(4/5);of the 15 patients in the cervical cancer group,0 was in complete remission,6 were in partial remission,6 were stable and 3 were progressive,with an objective efficiency rate of 40.0%(6/15)and a benefit rate of 80.0%(12/15).Of the 19 patients in the ovarian cancer group,0 was in complete remission,12 were in partial remission,5 were stable,and 2 were progressive,with an objective effective rate of 63.2%(12/19)and a benefit rate of 89.5%(17/19).The mean objective effective rate of the three groups was 61.1%and the mean benefit rate was 83.2%.There was no significant difference in the objective effective rate(P=0.292)and disease control rate(P=0.584)in all 3 groups.After intratumoral injection of chemotherapeutic agents,CA125 levels decreased in ovarian cancer patients(P=0.017).Conclusion Ultrasound-guided intratumoral injection of chemotherapeutic agents into refractory recurrent pelvic malignant tumors provides some disease control and reduces the CA125 level.