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目的 评价动脉灌注化疗药物治疗乳腺癌病例临床疗效。方法 采用Seldinger法经皮股动脉穿刺 ,将导管置于锁骨下动脉与胸廓内动脉开口交界处的近侧 ,用充气止血带高于患者收缩压阻断患侧肱动脉血流后 ,注入化疗药物 ,根据患者情况 3～ 4周重复灌注化疗。化疗方案 :环磷酰胺 (CTX ) 2 0 0～ 40 0mg/m2 、阿霉素 (ADR )或表阿霉素 (EADR ) 5 0～ 70mg/m2 、5 氟尿嘧啶(5 FU ) 75 0～ 10 0 0mg/m2 、甲酰四氢叶酸钙 (CF) 10 0～ 2 0 0mg。 结果 本组 65例 ,随访 8个月～ 11年 (平均 5 0个月 ) ,CR 4例 ,PR 47例 ,MR 14例 ,总缓解率 (CR +PR) 78.5 % ;11例曾接受全身化疗者 ,PR 8例、MR 3例 ;5例曾行局部放疗者均为PR。结论 动脉内灌注化疗药物对提高乳腺癌的生存率有积极意义 ,且对全身化疗或局部放疗无效果者仍有可能通过动脉灌注取得较好效果。
Objective To evaluate the clinical efficacy of arterial infusion chemotherapy in the treatment of breast cancer. Methods Seldinger percutaneous femoral artery puncture catheter placed in the subclavian artery and thoracic artery at the junction of the proximal opening with inflatable tourniquet higher than the patient’s systolic blood pressure blocking the affected side of the brachial artery after injection of chemotherapy drugs , According to the patient’s condition 3 to 4 weeks repeated infusion chemotherapy. Chemotherapy regimen: CTX 200 ~ 40 0mg / m2, doxorubicin (ADR) or epirubicin (EADR) 50 ~ 70mg / m2, 5 fluorouracil 75 0 ~ 100 0mg / m2, leucovorin (CF) 10 0 ~ 200mg. Results The group of 65 patients were followed up for 8 months to 11 years (mean, 50 months). There were 4 patients with CR, 47 with PR, and 14 with MR. The overall response rate (CR + PR) was 78.5%. Eleven patients who had received systemic chemotherapy PR 8 cases, MR 3 cases; 5 cases had undergone local radiotherapy were PR. Conclusion Intra-arterial chemotherapeutic drugs have a positive effect on improving the survival rate of breast cancer, and it is still possible to obtain better results through arterial perfusion for those who have no effect on systemic chemotherapy or local radiotherapy.