CAJ | 학술논문

目的分析经双侧子宫动脉灌注化疗栓塞治疗宫颈癌的临床价值.方法对病理证实的28例子宫颈癌患者行双侧子宫动脉灌注化疗栓塞术，化疗药物选用顺铂(DDP)、表阿霉素(EADM)、丝裂霉素(MMC)、平阳霉素(PYM)和博来霉素(BLM)，栓塞物选用明胶海绵，海藻微球酸钠或PVA.通过治疗前后患者临床症状和瘤体变化情况进行疗效评价.结果病理证实28例宫颈癌患者中，鳞癌25例，腺癌3例.按照FIGO临床分期：Ⅰ期1例、Ⅱ期23例、Ⅲ期4例.28例52支子宫动脉超选插管成功并给予栓塞化疗；4支子宫动脉未能插入者仅给予髂内动脉灌注化疗；28例患者均仅行1次介入治疗，术后1周后症状缓解率92.8%.介入治疗后手术切除21例，结合放疗7例.主要不良反应为发热、白细胞下降、恶心、呕吐和腹痛.结论子宫动脉化疗栓塞是宫颈癌综合治疗的重要新辅助治疗之一.
목적분석경쌍측자궁동맥관주화료전새치료궁경암적림상개치.방법대병리증실적28례자궁경암환자행쌍측자궁동맥관주화료전새술，화료약물선용순박(DDP)、표아매소(EADM)、사렬매소(MMC)、평양매소(PYM)화박래매소(BLM)，전새물선용명효해면，해조미구산납혹PVA.통과치료전후환자림상증상화류체변화정황진행료효평개.결과병리증실28례궁경암환자중，린암25례，선암3례.안조FIGO림상분기：Ⅰ기1례、Ⅱ기23례、Ⅲ기4례.28례52지자궁동맥초선삽관성공병급여전새화료；4지자궁동맥미능삽입자부급여가내동맥관주화료；28례환자균부행1차개입치료，술후1주후증상완해솔92.8%.개입치료후수술절제21례，결합방료7례.주요불량반응위발열、백세포하강、악심、구토화복통.결론자궁동맥화료전새시궁경암종합치료적중요신보조치료지일.
Objective To discuss the clinical therapeutic effect and side reaction of bilateral superselective uterine arterial chemoembolization therapy for the treatment of cervical cancer. Methods Bilateral uterinearterial chemoembolization was performed in 28 patients with pathologically-proved cervical cancer. The infusion drugs included DDP , EADM, MMC ,PYMand BLM. The Gelfoam particle , Seaweed sodium microspheres or PVA was employed as embolic agent. The therapeutic effect was evaluated by observing the improvement of clinical symptoms and the volume reduction of the tumor. Results Of the total 28 patients with pathologically-confirmed cervical cancer, squamous cell carcinoma was seen in 25 and adenocarcinoma in 3. Based on FIGO classification (established by Federation International of Gynecology and Obstetrics),1,23 and 4 patients were classified in stage Ⅰ,Ⅱand Ⅲ respectively. The angiography conducted during the procedure showed that the uterine arteries were markedly dilated, and spiral tumor-feeding arteries as well as tumor stain were also observed. Technical success together with perfect chemoembolization was achieved for 52 uterine arteries in 28 patients.All the 28 patients, the interventional treatment was only carried out one time. One week after the initial interventional procedure the remission rate of the clinical symptoms was92.8%.Surgical resection after interventional therapy was carried out in 21 cases and additional radiotherapy after surgery or interventional procedure was adopted in 7 cases. The main adverse reactions after interventional procedure included fever, leukocytopenia, nausea,vomiting, abdominal pain, etc. Conclusion Superselective uterine arterial chemoembolization is one of effective supplementary measures for the comprehensive treatment of cervical carcinoma.