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目的探讨中晚期宫颈癌术前动脉灌注化疗栓塞的临床价值。方法选择2005年6月2009年12月35例经阴道镜活检确诊为宫颈癌临床分期Ⅱa～Ⅲb期宫颈癌患者,术前行1次子宫动脉化疗栓塞,化疗药物为博莱霉素(BLM)+顺铂(DDP)+环磷酰胺(CTX),栓塞剂为超液化碘油加明胶海绵颗粒。介入治疗后14～20d行子宫全切加淋巴结清扫术。观察动脉灌注化疗栓塞前后肿块的大小变化、术中肿块粘连状况及出血量的多少。结果经介入治疗后肿块缩小32例:完全缓解(CR)3例、部分缓解(PR)29例,肿块无变化(NC)2例,进展(PD)1例,治疗有效率为91.4%。31例选择了手术治疗,手术率为88.6%。术中肿块粘连状况:无粘连24例,轻度粘连6例,中度粘连1例。术中出血量:≤100mL7例,100～200mL18例,200～400mL6例。结论中晚期宫颈癌术前动脉灌注化疗栓塞能有效地提高肿瘤切除率,降低手术风险。
Objective To investigate the clinical value of preoperative arterial chemoembolization in advanced cervical cancer. Methods June 2005 December 2009 35 cases of cervical cancer confirmed by colposcopy biopsy clinical stage Ⅱ a ~ Ⅲ b cervical cancer patients, preoperative uterine arterial chemoembolization, chemotherapy drugs for bleomycin (BLM) + Cisplatin (DDP) + cyclophosphamide (CTX), embolization agent is liquefied lipiodol plus gelatin sponge particles. Interventional treatment of 14 ~ 20d hysterectomy with lymph node dissection. To observe the changes of the size of the tumor before and after arterial infusion chemoembolization, intraoperative tumor adhesion status and the amount of bleeding. Results After the interventional treatment, the tumor size was reduced in 32 cases. There were 3 cases of complete remission (CR), 29 cases of partial remission (PR), 2 cases of no change of mass (NC) and 1 case of progression (PD). The effective rate was 91.4%. 31 cases chose surgical treatment, the operative rate was 88.6%. Intraoperative adhesions: 24 cases without adhesion, 6 cases with mild adhesion, and 1 case with moderate adhesion. Intraoperative blood loss: ≤ 100mL7 cases, 100 ~ 200mL18 cases, 200 ~ 400mL6 cases. Conclusions The preoperative arterial chemoembolization in advanced cervical cancer can effectively improve the tumor resection rate and reduce the operation risk.