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(目的)通过术前尺动脉插管化疗,使肿瘤缩小,降低肿瘤分期,使原来难以手术的病例获得手术根治或姑息切除。(方法)患者行尺动脉插管后,分别采用CMF、CAF或PAF三种化疗方案行动脉灌注化疗1~2周期。(结果)本组89例,其中Ⅲ期61例(Ⅲa期19例,Ⅲb期42例),Ⅳ期28例,多数患者于化疗后4~5天开始出现肿瘤退缩变软,3~4周后肿瘤缩小明显。局部有效率达95.5%,3年生存率:Ⅲa期83.3%,Ⅲb期74.2%,Ⅳ期42.9%,5年生存率分别为53.3%、35.4%、19.5%。(结论)术前区域动脉灌注化疗由于肿瘤内药物浓度高,可以有效杀灭癌细胞,缩小病灶,降低肿瘤分期,为手术争取机会,且尺动脉插管化疗还具有操作简单,给药方便,疗效确切,费用低廉,不增加手术后并发症等优点。
(Objective) Through preoperative ulnar arterial catheterization chemotherapy, the tumor shrinks, and the tumor stage is reduced, so that the original difficult-to-surgery case is treated with surgery or palliative resection. (Methods) After the ulnar arterial cannulation was performed, the patients were treated with CMF, CAF, or PAF for 1 to 2 cycles of arterial infusion chemotherapy. (Results) There were 89 cases in this group, including 61 cases in stage III (19 cases in stage IIIa, 42 cases in stage IIIb), and 28 cases in stage IV. The majority of patients began to have tumor shrinkage and become soft on 4 to 5 days after chemotherapy, and 3 to 4 weeks. After the tumor shrinks significantly. The local effective rate was 95.5%, and the 3-year survival rate was 83.3% in stage IIIa, 74.2% in stage IIIb, 42.9% in stage IV, and the 5-year survival rate was 53.3% and 35.4%, respectively. , 19.5%. (Conclusion) Preoperative regional arterial infusion chemotherapy can effectively kill cancer cells, reduce lesions, reduce tumor stage, and provide opportunities for surgery because of the high concentration of drugs in the tumor. The ulnar arterial cannulation chemotherapy also has simple operation and convenient administration. It has the advantages of exact curative effect, low cost, no increase in postoperative complications, etc.