摘要
目的探讨穿刺灌注化疗联合放疗治疗盆腔囊性恶性肿瘤疗效、安全性及临床应用价值。方法 55例盆腔囊性恶性肿物患者分为穿刺灌注化疗联合放疗组（n=28,观察组）和静脉化疗联合放疗组（n=27,对照组）。观察组通过CT引导下行经皮盆腔囊性恶性肿瘤穿刺置管术,局部灌注顺铂20～40mg化疗,对照组行静脉顺铂单药化疗,每次40mg/m2,每周1次,两组同步行盆腔三维适形放疗,总剂量50～60Gy,分割2Gy/次,5次/周。观察治疗效果及不良反应。结果观察组28例患者均一次性穿刺成功,整个穿刺置管操作时间18～42min,平均23min,未出现感染、出血、穿孔等并发症,未损伤血管、肠管、膀胱、前列腺、子宫、阴道等组织。观察组总有效率达100%,对照组为78.0%,两组比较差异有统计学意义（P〈0.01）。观察组局部缓解时间较对照组长,（14.26±2.61）月vs（10.76±1.97）月（P〈0.05）。观察组患者骨髓抑制、胃肠道反应、放射性直肠炎及放射性膀胱炎的不良反应发生率较对照组低（P〈0.05）。结论穿刺灌注化疗联合盆腔放疗治疗盆腔囊性恶性肿瘤临床疗效更佳,不良反应发生率低,值得进一步推广。
Objective To discuss the clinical application and experience of percutaneous puncture under CT guidance and perfusion chemotherapy with concurrent radiotherapy for pelvic cystic tumor.Methods Fifty-five patients received percutaneous pelvic cystic tumor puncture under CT guidance and perfusion chemotherapy with cisplatin 20-40 mg（trial group,n =28）,or received intravenous chemotherapy with cisplatin 40 mg/m2 （control group, n =27）,concurrently with pelvic radiotherapy,2 Gy per fraction,5 fractions per week.The patients of two groups received the pelvic radiotherapy with a total dose 50-60 Gy.We observed the efficacy and toxic side effects.Results Twenty-eight patients were all punctured successfully at the first attempt,puncture times ranged between 18 and 42 min and the average time was 23 min.There were no infection,bleeding,perforation or any injury of blood vessels, bowel,bladder,prostate,uterus,vagina or any other tissue.The effective rate（CR＋PR）was 100% in trial group and 78.0% in control group,with significant difference between two groups （P 〈 0.01 ）.The progression free survival （PFS）was （14.26 ± 2.61 ）months in trial group and （10.76 ± 1.97 ）months in control group,with significant difference between two groups （P 〈0.05）.The main adverse effects were myelosuppression,gastrointestinal adverse reaction,radiation proctitis and radiocystitis,with significant difference between two groups （P 〈0.05）.Conclusion The percutaneous pelvic cystic tumor puncture under CT guidance and perfusion chemotherapy with concurrent radiotherapy was safe and effective.
出处
《临床荟萃》
CAS
2015年第9期1043-1046,共4页
Clinical Focus
