临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
9期
1043-1046
,共4页
毕然%刘立杰%靳甜%贾洪菊%关玲%张秋丽%李平%付占昭
畢然%劉立傑%靳甜%賈洪菊%關玲%張鞦麗%李平%付佔昭
필연%류립걸%근첨%가홍국%관령%장추려%리평%부점소
盆腔肿瘤%体层摄影术,X 线计算机%穿刺术%输注,胃肠外%放射疗法%药物疗法,联合
盆腔腫瘤%體層攝影術,X 線計算機%穿刺術%輸註,胃腸外%放射療法%藥物療法,聯閤
분강종류%체층섭영술,X 선계산궤%천자술%수주,위장외%방사요법%약물요법,연합
pelvic neoplasms%tomography computed,X-ray%puncture%infusions,parenteral%radiotherapy%drug therapy,combination
目的：探讨穿刺灌注化疗联合放疗治疗盆腔囊性恶性肿瘤疗效、安全性及临床应用价值。方法55例盆腔囊性恶性肿物患者分为穿刺灌注化疗联合放疗组(n =28,观察组)和静脉化疗联合放疗组(n =27,对照组)。观察组通过 CT 引导下行经皮盆腔囊性恶性肿瘤穿刺置管术,局部灌注顺铂20~40 mg 化疗,对照组行静脉顺铂单药化疗,每次40 mg/m2,每周1次,两组同步行盆腔三维适形放疗,总剂量50~60 Gy,分割2 Gy/次,5次/周。观察治疗效果及不良反应。结果观察组28例患者均一次性穿刺成功,整个穿刺置管操作时间18~42 min,平均23 min,未出现感染、出血、穿孔等并发症,未损伤血管、肠管、膀胱、前列腺、子宫、阴道等组织。观察组总有效率达100%,对照组为78.0%,两组比较差异有统计学意义(P <0.01)。观察组局部缓解时间较对照组长,(14.26±2.61)月 vs (10.76±1.97)月(P <0.05)。观察组患者骨髓抑制、胃肠道反应、放射性直肠炎及放射性膀胱炎的不良反应发生率较对照组低(P <0.05)。结论穿刺灌注化疗联合盆腔放疗治疗盆腔囊性恶性肿瘤临床疗效更佳,不良反应发生率低,值得进一步推广。
目的：探討穿刺灌註化療聯閤放療治療盆腔囊性噁性腫瘤療效、安全性及臨床應用價值。方法55例盆腔囊性噁性腫物患者分為穿刺灌註化療聯閤放療組(n =28,觀察組)和靜脈化療聯閤放療組(n =27,對照組)。觀察組通過 CT 引導下行經皮盆腔囊性噁性腫瘤穿刺置管術,跼部灌註順鉑20~40 mg 化療,對照組行靜脈順鉑單藥化療,每次40 mg/m2,每週1次,兩組同步行盆腔三維適形放療,總劑量50~60 Gy,分割2 Gy/次,5次/週。觀察治療效果及不良反應。結果觀察組28例患者均一次性穿刺成功,整箇穿刺置管操作時間18~42 min,平均23 min,未齣現感染、齣血、穿孔等併髮癥,未損傷血管、腸管、膀胱、前列腺、子宮、陰道等組織。觀察組總有效率達100%,對照組為78.0%,兩組比較差異有統計學意義(P <0.01)。觀察組跼部緩解時間較對照組長,(14.26±2.61)月 vs (10.76±1.97)月(P <0.05)。觀察組患者骨髓抑製、胃腸道反應、放射性直腸炎及放射性膀胱炎的不良反應髮生率較對照組低(P <0.05)。結論穿刺灌註化療聯閤盆腔放療治療盆腔囊性噁性腫瘤臨床療效更佳,不良反應髮生率低,值得進一步推廣。
목적：탐토천자관주화료연합방료치료분강낭성악성종류료효、안전성급림상응용개치。방법55례분강낭성악성종물환자분위천자관주화료연합방료조(n =28,관찰조)화정맥화료연합방료조(n =27,대조조)。관찰조통과 CT 인도하행경피분강낭성악성종류천자치관술,국부관주순박20~40 mg 화료,대조조행정맥순박단약화료,매차40 mg/m2,매주1차,량조동보행분강삼유괄형방료,총제량50~60 Gy,분할2 Gy/차,5차/주。관찰치료효과급불량반응。결과관찰조28례환자균일차성천자성공,정개천자치관조작시간18~42 min,평균23 min,미출현감염、출혈、천공등병발증,미손상혈관、장관、방광、전렬선、자궁、음도등조직。관찰조총유효솔체100%,대조조위78.0%,량조비교차이유통계학의의(P <0.01)。관찰조국부완해시간교대조조장,(14.26±2.61)월 vs (10.76±1.97)월(P <0.05)。관찰조환자골수억제、위장도반응、방사성직장염급방사성방광염적불량반응발생솔교대조조저(P <0.05)。결론천자관주화료연합분강방료치료분강낭성악성종류림상료효경가,불량반응발생솔저,치득진일보추엄。
Objective To discuss the clinical application and experience of percutaneous puncture under CT guidance and perfusion chemotherapy with concurrent radiotherapy for pelvic cystic tumor.Methods Fifty-five patients received percutaneous pelvic cystic tumor puncture under CT guidance and perfusion chemotherapy with cisplatin 20-40 mg(trial group,n =28),or received intravenous chemotherapy with cisplatin 40 mg/m2 (control group, n =27),concurrently with pelvic radiotherapy,2 Gy per fraction,5 fractions per week.The patients of two groups received the pelvic radiotherapy with a total dose 50-60 Gy.We observed the efficacy and toxic side effects.Results Twenty-eight patients were all punctured successfully at the first attempt,puncture times ranged between 18 and 42 min and the average time was 23 min.There were no infection,bleeding,perforation or any injury of blood vessels, bowel,bladder,prostate,uterus,vagina or any other tissue.The effective rate(CR+PR)was 100% in trial group and 78.0% in control group,with significant difference between two groups (P < 0.01 ).The progression free survival (PFS)was (14.26 ± 2.61 )months in trial group and (10.76 ± 1.97 )months in control group,with significant difference between two groups (P <0.05).The main adverse effects were myelosuppression,gastrointestinal adverse reaction,radiation proctitis and radiocystitis,with significant difference between two groups (P <0.05).Conclusion The percutaneous pelvic cystic tumor puncture under CT guidance and perfusion chemotherapy with concurrent radiotherapy was safe and effective.
