ⅲ期乳腺癌术前介入化疗栓塞的临床观察.docVIP

Ⅲ期乳腺癌术前介入化疗栓塞的临床观察 nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; 作者：黄士勇 杜玉清 周为中 胡文豪 董礼阳 陈远志 【摘要】nbsp; 目的 探讨Ⅲ期乳腺癌术前动脉化疗栓塞的近期临床疗效。方法 采用Seldinger技术将导管插至肿瘤血管内，灌注顺铂(DDP)60～80mg、吡柔比星（THP）50～60mg、氟脲嘧啶脱氧核苷(FuDR)1000～1250mg药物和适量明胶海绵栓塞治疗16例Ⅲ期乳腺癌病人,2～8周后行根治手术，术后给予化疗和放疗或内分泌治疗。 结果 16例Ⅲ期乳腺癌采用介入化疗栓塞后，肿块和转移淋巴结均有明显缩小；根治术后随访2～5年,13例无癌生存期达5年以上，与同期未作介入治疗者相比，手术时间缩短和术中出血量减少［(88.7500±8.5674）ml,（102.5200±13.799）ml,t=3.5667,Plt;0.05;（1.7563±0.1580）h,（2.0280±0.1568）h,t=5.3967,Plt;0.05］, 创口种植、伤口感染、皮瓣坏死等手术并发症未见增加(Pgt;0.05)。结论 Ⅲ期乳腺癌术前介入化疗栓塞疗效明显，增加手术切除机会，减少术中出血和缩短手术时间。 【关键词】nbsp; 乳腺癌 化疗栓塞 介入放射学 【Abstract】nbsp; Objectivenbsp; To investigate the clinical effect of preoperative intraarteial chemotherapy and embolization in breast cancer patients of stage Ⅲ. Methodsnbsp; Seldinger procedure was used to cathetered to the vascular of tumors, intra-arterial chemotherapy with DDP 60～80mg, THP 50～60mg, FuDR 1000～1250mg and embolization with gelatin sponge particle were given to 16 cases breast cancer patients of stage Ⅲ, operation was carried out after 2-8 weeks, and chemotherapy radiotherapy or endocrinetherapy was given after operation. Resultnbsp; The primary tumor foci and the metastatic LN in 16 cases breast cancer patients of stage Ⅲ all reduced after the interventional therapy. All patients underwent radical mastectomy afterwards and were followed-up for 2-5 years with 13 still alive without cancer for more than 5 years, the operation implication such as implantationnbsp; or infection of incisions, necrosis of skin flap was similar to those not receiving preoperative intervensive chemotherapy and embolization(Plt;0.05),Blood loss and operative time were significantly decreased in the preoperation chemo-embolization group as compared with not receiving preoperative intervensive chemotherapy and embolization group(88.7500?.5674ml, 102.5200?3.799ml, t=3.5667, Plt;0.05; 1.7563?.1580h, 2.0280?.1568h, t=5.3967,Plt;0.05). Conclusionnbsp; Preoperative intra-a