顺铂子宫动脉介入栓塞联合紫杉醇静脉化疗在局部晚期宫颈癌治疗中的应用

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摘要目的探讨顺铂子宫动脉介入栓塞联合紫杉醇静脉化疗在局部晚期宫颈癌治疗中的应用。方法回顾性分析我院2006年1月～2013年6月收治局部晚期宫颈癌患者152例，分为子宫动脉介入栓塞化疗组和静脉组。子宫动脉介入栓塞组又分为顺铂联合紫杉醇子宫动脉介入栓塞组（动脉组）52例和顺铂子宫动脉介入栓塞联合紫杉醇静脉化疗组（动脉+静脉组）54例。静脉组46例。三组患者均采用紫杉醇联合顺铂方案，紫杉醇135 mg/m2，顺铂70 mg/m2，治疗1～2个疗程，评估后行根治性子宫切除术及盆腔淋巴清扫术，观察三组患者临床疗效和不良反应发生率、手术完成率、患者术中出血量及手术时间、术后切缘阴性率、术后3年生存率。结果子宫动脉介入栓塞组化疗后瘤体均明显缩小，静脉组5例病情进展，子宫动脉介入栓塞组总有效率高于静脉组，差异有统计学意义（P＜0.05）。动脉+静脉组、动脉组、静脉组分别有47例、44例、30例完成开腹根治性子宫切除术及盆腔淋巴清扫术，组间比较，差异有统计学意义（P＜0.05）。动脉+静脉组手术时间［（180.1±40.4）min］、动脉组手术时间［（180.2± 30.3）min］均短于静脉组的（210.4±30.2）min，差异有统计学意义（P＜0.05）。动脉+静脉组出血量［（265.6±50.2）ml］、动脉组出血量［（280.2±55.1）ml］均少于静脉组的（350.6±45.7）ml，差异有统计学意义（P＜0.05）。子宫动脉介入栓塞组术后病理切缘阴性率高于静脉组，差异有统计学意义（P＜0.05）。术后3年所有患者均存活，无复发。结论顺铂子宫动脉介入栓塞联合紫杉醇静脉化疗，即保留子宫动脉介入栓塞化疗的优势，又减轻不良反应，是局部晚期宫颈癌新辅助化疗的一种较佳给药途径。

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	张淑珍
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关键词 ：宫颈癌, 新辅助化疗, 不良反应, 给药途径

Abstract：Objective To investigate the clinical combined application of uterine artery embolization with cisplatin and paclitaxel chemotherapy in the treatment of locally advanced cervical cancer patients.Methods Retrospectively analized 152 cases locally advanced cervical cancer patients in our hospital from January 2006 to June 2013.54 cases were combined treated by uterine artery embolization with cisplatin and intravenous chemotherapy（artery+vein group），while 52 cases were treated with uterine artery embolization with cisplatin（artery group），and 46 cases received intravenous chemotherapy（vein group）.Patients were treated with paclitaxel combined with cisplatin，paclitaxel 135 mg/m2and cisplatin 70 mg/m2，and received radical uterus resection surgery and lymph node dissection or radiation therapy after 1-2 courses.The clinical efficacy and adverse reaction，completion rate of the surgery，blood loss，the operation time，resection margin negative rate and postoperative 3 years survival rate of patients were observed.Results The tumor size of artery+ vein group and artery group were significantly reduced.5 cases of intravenous group had disease progression.The total effective rate of the artery+vein group and artery group were higher than that of intravenous group with statistical difference（P＜0.05）.There were 47cases，44 cases and 30 cases underwent uterine resection surgery and lymph node dissection in artery+vein group，artery group and intravenous group respectively with statistical difference（P＜0.05）.Operation time of artery+vein group and artery group were　（180.1±40.4），（180.2±30.3）min，shorter than　（210.4±30.2）min of intravenous group with statistical difference（P＜0.05）.Blood loss of artery+vein group and artery group were（265.6±50.2），（280.2±55.1）ml，less than （350.6±45.7）ml of intravenous group with statistical difference（P＜0.05）.The resection margin negative rate of the two groups was significantly higher than that of intravenous group with statistical difference（P＜0.05）.All patients were alive and without recurrence for 3 years after operation.Conclusion Cisplatin uterine artery embolization combined with paclitaxel intravenous chemotherapy can retain the advantages of uterine artery embolization chemotherapy，and reduce the adverse reactions.It is a better way to the neoadjuvant chemotherapy for locally advanced cervical cancer.

Key words： Cervical cancer Neoadjuvant chemotherapy Adverse drug reaction Route of administration

基金资助:福建省三明市科技计划项目（2016-L-18）

作者简介: 张淑珍（1973-），女，毕业于福建医科大学，研究方向：妇科肿瘤及妇科内分泌治疗

引用本文:

张淑珍;杨美;曾纯杰;王国东. 顺铂子宫动脉介入栓塞联合紫杉醇静脉化疗在局部晚期宫颈癌治疗中的应用[J]. 中国当代医药, 2016, 23(22): 116-119.
ZHANG Shu-zhen;YANG Mei;ZENG Chun-jie;WANG Guo-dong. Clinical combined application of uterine artery embolization with cisplatin and paclitaxel chemotherapy in locally advanced cervical cancer patients. 中国当代医药, 2016, 23(22): 116-119.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2016/V23/I22/116

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