子宫动脉灌注化疗加栓塞术在宫颈癌新辅助化疗中的临床研究

发布时间：2018-06-28 12:28

本文选题：宫颈癌 + 新辅助化疗　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的：通过对比新辅助化疗的全身静脉化疗和介入化疗加栓塞术的临床疗效,探讨子宫动脉灌注化疗加栓塞术在宫颈癌新辅助化疗中的价值、其对患者施行宫颈癌根治性手术的影响、及其能否改善患者的生存率的远期疗效。以图帮助临床医师在临床工作中根据患者的病情、经济条件及医院技术设备等综合评估,使用更科学和合理的新辅助化疗方式,对提高宫颈癌患者手术的安全性及预后有很大的临床意义。方法：回顾性分析90例局部晚期宫颈癌患者的临床资料,根据新辅助化疗的不同途径将其分组,其中术前行动脉插管灌注化学治疗加栓塞术(介入化疗组)44例,术前行全身静脉化学治疗(全身化疗组)46例。比较两组的临床疗效、不良反应、手术情况、病理学变化情况和远期疗效。结果：介入化疗组和静脉化疗组的癌灶消退情况均较好,介入化疗组的阴道流血缓解率(100%)较静脉化疗组(91.3%)的高,差异有统计学意义(P=0.001)；另外,静脉化疗组的手术术中出血量为(539.1±318.1)m1,介入化疗组的为(342.7±157.7)m1,两者差异亦有统计学意义(P=0.000)；两组的肿瘤缩小情况、骨髓抑制情况、胃肠道反应情况、手术间隔时间、手术时长及术后病理变化情况均相近,差异无统计学意义(P0.05)；介入化疗组3、5年生存率分别为89%、85%,复发率为15.9%；静脉化疗组的3、5年生存率分别为79%、79%,复发率为21.7%；差异无统计学意义(P均0.05)；两组生存曲线无显著性差异(P0.05)。结论：两种新辅助化疗方法对治疗宫颈癌均能较好的缩小癌灶,动脉灌注化疗加栓塞术能更好的缓解阴道流血,对避免术前贫血起到积极作用,且动脉灌注化疗加栓塞术能更好的减少术中出血量,提高手术的安全性。但对于远期疗效来说,动脉化疗加栓塞术与全身静脉化疗相比,未能降低患者的复发率和提高患者的3、5年生存率。
[Abstract]:Objective: to compare the clinical effects of systemic intravenous chemotherapy with neoadjuvant chemotherapy and interventional chemotherapy combined with embolization, and to explore the value of uterine artery infusion chemotherapy plus embolization in neoadjuvant chemotherapy for cervical cancer. Its effect on patients with cervical cancer radical surgery, and can improve the long-term survival rate of patients. In order to help clinicians use more scientific and reasonable new adjuvant chemotherapy methods in clinical work according to the comprehensive assessment of the patient's condition, economic conditions and hospital technical equipment, It is of great clinical significance to improve the safety and prognosis of cervical cancer patients. Methods: the clinical data of 90 patients with locally advanced cervical cancer were analyzed retrospectively. According to the different ways of neoadjuvant chemotherapy, 44 patients were treated with preoperative arterial infusion chemotherapy plus embolization (interventional chemotherapy group). Before operation, 46 patients were treated with systemic intravenous chemotherapy (systemic chemotherapy group). The clinical effects, adverse reactions, surgical conditions, pathological changes and long-term outcomes were compared between the two groups. Results: the remission rate of vaginal bleeding in interventional chemotherapy group (100%) was higher than that in intravenous chemotherapy group (91.3%), the difference was statistically significant (P0. 001). The amount of intraoperative bleeding was (539.1 卤318.1) ml in intravenous chemotherapy group and (342.7 卤157.7) ml in interventional chemotherapy group (P < 0.01). The 3- and 5-year survival rates in the interventional chemotherapy group were 890.The recurrence rate was 15.90.The 3- and 5-year survival rates in the intravenous chemotherapy group were 790.The recurrence rate was 21.7. There was no significant difference in survival curve between the two groups (P0.05). Conclusion: the two new adjuvant chemotherapy methods can reduce the cancer focus of cervical cancer, arterial infusion chemotherapy and embolization can relieve vaginal bleeding better, and play a positive role in the prevention of preoperative anemia. Arterial infusion chemotherapy combined with embolization can reduce intraoperative bleeding and improve the safety of the operation. However, compared with systemic intravenous chemotherapy, arterial chemotherapy and embolization can not reduce the recurrence rate and improve the 3- and 5-year survival rate.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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