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目的 探讨术中区域性动脉灌注化疗对子宫内膜癌的治疗效果。方法 回顾性分析我院 2 0 0 0年 1月～ 2 0 0 2年 11月间在我科施行了术中动脉灌注化疗的 2 0例子宫内膜癌患者 (灌注组 ) ,选择同期手术治疗的子宫内膜癌患者 33例为对照 (对照组 ) ,分析两组的复发及死亡情况。结果 灌注组中Ⅰ期 8例 ,Ⅱ期 8例 ,Ⅲ期 4例 ,Ⅳ 0例 ,其中 1例ⅢaG2者于术后 8个月盆腔复发 ,无 1例死亡 ,复发率为 5 0 %。对照组中Ⅰ期 2 5例 ,Ⅱ期 3例 ,Ⅲ期 4例 ,Ⅳ 1例 ,其中 3例复发 ,复发率为 9 1%。复发者分别为ⅠbG2 - 3,ⅠcG3和ⅢcG3,1例为阴道断端复发 ,1例为盆腔复发 ,1例为远处脏器转移 ,其中 2例死亡 ,死亡率为 6 1%。两组的平均随访时间为 15 6± 5 2 (个月 )及 16 8± 7 4 (个月 ) ,差异无显著性 (P >0 0 5 )。结论 术中髂内动脉灌注化疗可降低子宫内膜癌的复发率 ,且操作简单易于掌握 ,既具有术前选择性动脉灌注化疗的优点又可避免其弊端 ,值得临床推广。
Objective To investigate the effect of regional intra-arterial infusion chemotherapy for endometrial cancer. Methods A retrospective analysis of 20 cases of endometrial cancer patients (perfusion group) undergoing intra-arterial infusion chemotherapy in our department from January 2000 to November 2002 was performed. Surgical treatment Of 33 patients with endometrial cancer as a control (control group), analysis of the two groups of recurrence and death. Results In the perfusion group, there were 8 cases in stage Ⅰ, 8 cases in stage Ⅱ, 4 cases in stage Ⅲ, and 4 cases in stage Ⅳ. One case of ⅢaG2 recurred in pelvic cavity 8 months after operation. No one died and the recurrence rate was 50%. In the control group, 25 cases were stage Ⅰ, 3 cases were stage Ⅱ, 4 cases were stage Ⅲ, and 1 was stage Ⅳ. Among them, 3 cases relapsed and the recurrence rate was 91%. The recurrences were ⅠbG2 - 3, ⅠcG3 and ⅢcG3, 1 case was recurrence of vaginal fracture, 1 case was pelvic recurrence and 1 case was distant organ metastasis, of which 2 cases died and the mortality rate was 61%. The mean follow-up time was 15 6 ± 5 2 months and 16 8 ± 7 4 months in both groups, with no significant difference (P> 0.05). Conclusion Intra-arteria iliac artery infusion chemotherapy can reduce the recurrence rate of endometrial cancer, and the operation is simple and easy to master. It not only has the advantages of preoperative selective arterial infusion chemotherapy but also avoids its disadvantages and is worthy of clinical promotion.