卵巢癌术前介入化疗的应用

Application of Preoperative Interventional Chemotherapy for Ovarian Carcinomas

目的 :观察卵巢癌术前介入化疗的临床效果、彩超改变、CA12 5改变、术中所见及术后病理改变。方法 :对 5例卵巢癌患者实施术前介入性化疗 ,抗癌药物选用卡铂、紫杉醇进行双侧髂内动脉灌注加栓塞治疗。结果 :5例患者经 1～ 2个疗程的介入化疗后临床症状明显减轻 ,腹水消失 ,彩超均显示肿瘤有液化 ,周围血流减少 ,CA12 5水平明显下降 ,术中发现肿瘤质脆、盆腔粘连易分离 ,手术易切除 ,术后病理切片发现大量坏死组织及淋巴细胞侵润。结论 :对手术困难的卵巢癌晚期患者术前给予介入化疗可有效地杀灭肿瘤细胞 ,使大部分患者临床分期得到逆转从而获得手术机会 。

Objective: To observe the effect of preoperative interventional chemotherapy in ovarian carcinomas treatment, including the change of color doppler and CA 125 what is seen in operation and the pathological change after operation. Methods: The preoperative arterial chemoembolization by catherization of both internal iliac arteries on 5 patients with locally advanced ovarian carcinomas was conducted for 7 times, selecting carboplatinum and taxol as drugs. Results: After 1 to 2 times of interventional chemotherapy, the clinic symptoms of five cases were obviously lightened; abdominal water disappeared; color doppler showed the liquefaction of tumor tissues; the blood flow around the tumor was reduced; the CA 125 level obviously descended; in operation, the tumor tissues were detected to be fragile; pelvic adhesions were easily dispersed, and the tumor tissues were easily resectable by operation; postoperative mass necrosis and lymphocyte cell infiltration were found in the tumor tissues. Conclusion: Interventional therapy is an effective method for unresectable advanced gynecologic malignant neoplasm, by which the tumor stage can be changed so that chances of operation and conditions for following treatment can be obtained.