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妇科恶性肿瘤淋巴结转移的腹膜后与腹腔化学治疗的比较 |
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曹泽毅 张丹 彭芝兰 周世英 黎培毅 杨延林 张崇淑 尤宗兵
【摘要】 目的 比较妇科恶性肿瘤患者淋巴结转移的腹膜后化学治疗(化疗)和腹腔化疗的疗效，并进一步评价腹膜后化疗。方法 选择62例妇科恶性肿瘤患者，手术前分别随机进行腹膜后化疗43例、腹腔化疗重复给药11例和腹腔化疗单次注药(5氟尿嘧啶，5-FU)8例，采用高效液相色谱测定法(HPLC)检测淋巴结内5-FU的浓度。其中16例腹膜后化疗重复给药患者，比较注药侧与未注药侧淋巴结内5-FU的浓度。选择腹膜后化疗患者6例，分别经盆腔腹膜外间隙注入锝-硫化锑和伊索显-300各3例，分别采用单光子发射计算机体层摄影术和X线摄片，观察药物分布的范围。结果 (1)腹主动脉旁淋巴结5-FU浓度，腹膜后化疗是腹腔化疗的76～119倍；盆腔淋巴结5-FU的浓度，腹膜后化疗是腹腔化疗的66～106倍；(2)腹膜后化疗重复注药，注药侧5-FU浓度为未注药侧的16～20倍；(3)腹膜后化疗与腹腔化疗均无明显的毒副作用；(4)经盆腔腹膜外间隙给药，药物能从盆腔上行至腹主动脉旁淋巴结及其周围。结论 对于有淋巴转移的妇科恶性肿瘤的治疗，采用腹膜后途径重复给药化疗的疗效，明显优于腹腔化疗。
【关键词】 生殖器肿瘤，女性 药物疗法 淋巴转移 氟尿嘧啶
The Contrast between Chemotherapy via Pelvic Retroperitoneal Cannulation and Intraperitoneal Chemotherapy in Gynecological Malignancies Cancers with Lymph Node Metastases
CAO Zeyi, ZHANG Dan, PENG Zhilan, et al.
The Second Affiliated Hospital, West China University of Medical Sciences, Chengdu 610041
【Abstract】 Objective To contrast the pelvic retroperitoneal (RP) chemotherapy with intraperitoneal (IP) chemotherapy in gynecological malignancies with lymph node metastases. Methods Fluorouracil (5-FU) was repeatedly injected into the pelvic retroperitoneal space of 43 patients and the abdominal cavity of 11 patients. High performance liquid chromatography was used to determine the drug concentration of 5-FU. 5-FU was repeatedly injected into the pelvic retroperitoneal space of 16 patients via cannulation to observe the nodal 5-FU concentration of injected side and the control side.99m Tc-Sb2S3, Isovist-300 were injected into the pelvic retroperitoneal space of two groups (each one has 3 patients) respectively via cannulation. Single proton emission computer tomography (SPECT) and X-Ray film were taken to observe the allocation of the drugs. Results (1) Pelvic and periaortic nodal 5-FU concentrations of RP were 60～106 and 76～119 times of that of IP respectively. (2) The nodal 5-FU concentrations on repeated injection side were 16～20 times of that on[1] [2] 下一页
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