子宫颈癌患者子宫动脉插管与静脉全身化疗两种途径新辅助化疗对比
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摘要
目的:探讨子宫颈癌患者子宫动脉插管与静脉全身化疗两种途径新辅助化疗对比。方法:将2016年11月～2017年11月在某院肿瘤科治疗的86例子宫颈癌患者按化疗方式不同分为两组,对照组采用静脉全身化疗,观察组采用子宫动脉插管化疗,比较两组患者的化疗总有效率、毒副反应发生率、可手术率及手术情况、术后病理情况。结果:观察组化疗总有效率为83.72%,与对照组的79.07%相比,差异无统计学意义(P>0.05);观察组胃肠道反应、肝功能损害、末梢神经毒性、骨髓抑制、疼痛伴发热等毒副反应发生率与对照组相比无明显差异(P>0.05);观察组可手术率、手术时间、术中出血量、并发症发生率与对照组相比无明显差异(P>0.05);观察组术后宫旁受浸率明显低于对照组(P<0.05),而两组在淋巴结转移率、脉管癌栓率、宫颈肌层浸润率方面无明显差异(P>0.05)。结论:子宫颈癌患者子宫动脉插管与静脉全身化疗两种途径新辅助化疗的总体疗效相当,且手术率及手术难度、毒副反应方面也无明显区别,但子宫动脉插管化疗的宫旁受浸率更低,临床可根据患者的实际情况选择化疗方式。
Objective: To explore the contrast of neoadjuvant chemotherapy for uterine artery intubation and intravenous chemotherapy in patients with cervical cancer. Methods: 86 cases of cervical cancer patients treated in the oncology department of a hospital from November 2016 to November 2017 were divided into two groups according to different chemotherapy methods. Control group was treated with intravenous systemic chemotherapy, observation group was trated with uterine artery intubation chemotherapy. The total effective rate of chemotherapy, incidence of toxic and side effects, operative rate, operative status and postoperative pathology were compared between the two groups. Results: The total effective rate of chemotherapy in the observation group was 83.72%, compared with 79.07% in the control group, the difference was not statistically significant(P>0.05). The incidence of gastrointestinal reaction, liver function damage, peripheral neurotoxicity, bone marrow suppression, pain accompanied by fever and other adverse reactions in the observation group showed no significant difference compared with the control group(P>0.05). The operative rate, operation time, intraoperative hemorrhage and complication rate were not significantly different in the observation group(P>0.05). In the observation group, the infiltration rate was significantly lower than the control group(P<0.05), while there was no significant difference between the two groups in lymph node metastasis, vascular cancer thrombolysis rate, and cervical muscle infiltration rate(P>0.05). Conclusion: The overall efficacy of neoadjuvant chemotherapy is comparable between uterine arterial intubation and intravenous systemic chemotherapy in patients with cervical cancer, there was no significant difference in the operative rate, surgical difficulty and toxic and side effects, but the uterine artery intubation chemotherapy had a lower peruterine immersion rate, and the chemotherapy method could be selected clinically according to the actual situation of patients.
Objective: To explore the contrast of neoadjuvant chemotherapy for uterine artery intubation and intravenous chemotherapy in patients with cervical cancer. Methods: 86 cases of cervical cancer patients treated in the oncology department of a hospital from November 2016 to November 2017 were divided into two groups according to different chemotherapy methods. Control group was treated with intravenous systemic chemotherapy, observation group was trated with uterine artery intubation chemotherapy. The total effective rate of chemotherapy, incidence of toxic and side effects, operative rate, operative status and postoperative pathology were compared between the two groups. Results: The total effective rate of chemotherapy in the observation group was 83.72%, compared with 79.07% in the control group, the difference was not statistically significant(P>0.05). The incidence of gastrointestinal reaction, liver function damage, peripheral neurotoxicity, bone marrow suppression, pain accompanied by fever and other adverse reactions in the observation group showed no significant difference compared with the control group(P>0.05). The operative rate, operation time, intraoperative hemorrhage and complication rate were not significantly different in the observation group(P>0.05). In the observation group, the infiltration rate was significantly lower than the control group(P<0.05), while there was no significant difference between the two groups in lymph node metastasis, vascular cancer thrombolysis rate, and cervical muscle infiltration rate(P>0.05). Conclusion: The overall efficacy of neoadjuvant chemotherapy is comparable between uterine arterial intubation and intravenous systemic chemotherapy in patients with cervical cancer, there was no significant difference in the operative rate, surgical difficulty and toxic and side effects, but the uterine artery intubation chemotherapy had a lower peruterine immersion rate, and the chemotherapy method could be selected clinically according to the actual situation of patients.
引文
1 许晓峰.子宫动脉栓塞化疗与静脉全身化疗治疗宫颈癌的临床效果对比研究.中国实用医刊,2011,38(18):24～26.
2 佟锐,王纯雁.子宫动脉介入栓塞与PICC静脉用药新辅助化疗治疗局部进展期宫颈癌的临床效果对比研究.临床和实验医学杂志,2014,13(3):210～213.
3 张晓英,王飞鹏,张新选,等.子宫动脉栓塞灌注化疗对宫颈癌的局部微淋巴管密度和血管内皮生长因子的影响.广西医科大学学报,2017,34(10):1489～1492.
4 张爱东,刘卫云,于海红,等.子宫动脉灌注栓塞化疗治疗局部晚期宫颈癌的临床疗效观察.河北医学,2016,22(4):629～631.
5 张艺,欧阳振波,谢元媚,等.新辅助子宫动脉栓塞化疗与静脉化疗治疗宫颈癌的疗效比较.肿瘤学杂志,2017,23(9):829～831.
6 刘宁.全身静脉化疗和髂内动脉栓塞灌注化疗对宫颈癌微淋巴管密度和血管内皮生长因子表达的影响.现代中西医结合杂志,2016,25(5):524～526.
7 刘翼.子宫颈癌新辅助化疗不同给药途径对疗效的影响.实用癌症杂志,2014,29(3):308～310.
8 张淑珍,杨美,曾纯杰,等.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.中国当代医药,2016,23(22):116～119.
9 蒋瑜.动静脉不同给药途径新辅助化疗治疗局部晚期宫颈癌临床对比.中国综合临床,2013,29(10):1098～1100.
10 兰为顺,胡道予,杨文忠,等.基于介入治疗的两种新辅助化疗方案在局部晚期宫颈癌疗效的比较.放射学实践,2013,28(6):678～681.
2 佟锐,王纯雁.子宫动脉介入栓塞与PICC静脉用药新辅助化疗治疗局部进展期宫颈癌的临床效果对比研究.临床和实验医学杂志,2014,13(3):210～213.
3 张晓英,王飞鹏,张新选,等.子宫动脉栓塞灌注化疗对宫颈癌的局部微淋巴管密度和血管内皮生长因子的影响.广西医科大学学报,2017,34(10):1489～1492.
4 张爱东,刘卫云,于海红,等.子宫动脉灌注栓塞化疗治疗局部晚期宫颈癌的临床疗效观察.河北医学,2016,22(4):629～631.
5 张艺,欧阳振波,谢元媚,等.新辅助子宫动脉栓塞化疗与静脉化疗治疗宫颈癌的疗效比较.肿瘤学杂志,2017,23(9):829～831.
6 刘宁.全身静脉化疗和髂内动脉栓塞灌注化疗对宫颈癌微淋巴管密度和血管内皮生长因子表达的影响.现代中西医结合杂志,2016,25(5):524～526.
7 刘翼.子宫颈癌新辅助化疗不同给药途径对疗效的影响.实用癌症杂志,2014,29(3):308～310.
8 张淑珍,杨美,曾纯杰,等.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.中国当代医药,2016,23(22):116～119.
9 蒋瑜.动静脉不同给药途径新辅助化疗治疗局部晚期宫颈癌临床对比.中国综合临床,2013,29(10):1098～1100.
10 兰为顺,胡道予,杨文忠,等.基于介入治疗的两种新辅助化疗方案在局部晚期宫颈癌疗效的比较.放射学实践,2013,28(6):678～681.
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