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目的探讨介入性化疗不同栓塞方式对巨块型(直径≥4 cm)子宫颈癌的疗效及其副反应的比较。方法回顾分析能完成子宫动脉(单或双侧)超选择插管的52例巨块型子宫颈癌患者的临床病理资料,分为超液化碘油与丝裂霉素混悬剂栓塞肿瘤供血动脉后续化疗药物灌注组(A组)28例及灌注2/3量化疗药物后用携带有化疗药物(1/3量)的明胶海绵颗粒栓塞肿瘤供血动脉(B组)24例,并对两组的疗效和毒副反应进行比较。结果两组的化疗有效率和化疗后手术率比较差异统计学意义(P>0.05)。A组1次介入术后肿块缩小率为43.4%-62.7%。坏死率为78%-91%,均明显高于B组的31.1%-40.3%及54%-77%(P<0.05)。介入化疗期间两组均无不能耐受的毒副反应,但动脉栓塞并发症A组病例较B组严重。A组2年复发率为5.3%,明显低于B组的20%(P<0.05)。结论巨块型子宫颈癌介入栓塞化疗安全有效,而缩小肿瘤和降低术后复发率以应用超液化碘油等末梢栓塞剂较佳。
Objective To investigate the curative effect and side effects of different embolic methods of interventional chemotherapy on giant-type (≥4 cm in diameter) cervical cancer. Methods The clinical data of 52 patients with massive cervical cancer who underwent superselective uterine artery (unilateral or bilateral) cannulation were retrospectively analyzed. The patients were divided into two groups: hyperlipemic lipiodol and mitomycin - Twenty-eight patients in the subsequent chemotherapeutic drug infusion group (group A) and 24 patients in the second group (24 patients in the second group) were treated with gelatin sponge particles containing 1/3 of the chemotherapeutic drugs (group B) The efficacy and toxicity were compared. Results The two groups of chemotherapy efficiency and postoperative chemotherapy rates were statistically significant difference (P> 0.05). In group A, the reduction rate of lumps after one intervention was 43.4% -62.7%. The necrosis rate was 78% -91%, which were significantly higher than 31.1% -40.3% and 54% -77% in group B (P <0.05). During the interventional chemotherapy, there was no unacceptable side effects in both groups, but the complication of arterial embolism was more serious in group A than in group B. The 2-year recurrence rate in group A was 5.3%, significantly lower than that in group B (20%, P <0.05). Conclusion It is safe and effective to use massive embolization chemotherapy for embolization of cervical cancer. To reduce the tumor size and reduce the postoperative recurrence rate, it is better to use peripheral embolization agents such as hyperlipemic iodized oil.