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目的评价新辅助双侧髂内动脉前干灌注化疗栓塞在晚期卵巢上皮性癌治疗中的作用。方法1994年5月至2004年6月选择天津医科大学总医院晚期卵巢上皮性癌患者119例分成3组,其中研究组采用超选择性双侧髂内动脉前干灌注化疗栓塞+肿瘤细胞减灭术+辅助化疗,对照1组采用肿瘤细胞减灭术+术日开始辅助化疗的治疗方案,对照2组则采用肿瘤细胞减灭术+术后第3天开始辅助化疗的治疗方案。对各组理想肿瘤细胞减灭术成功率、术中失血量、手术时间及存活率进行对比研究。结果研究组肿瘤体积有不同程度的缩小,理想肿瘤细胞减灭术成功率比对照1组和2组均明显提高(71.43%∶48.84%∶50%),失血量及手术时间均较对照组明显减少和缩短。研究组总的平均存活时间为26个月,平均无病存活时间为18.2个月,较对照1组比较差异无统计学意义,与对照2组比较有明显统计学意义。结论新辅助双侧髂内动脉前干灌注化疗栓塞可有效提高晚期卵巢上皮性癌理想肿瘤细胞减灭术手术成功率,降低手术难度,减少术中出血,缩短手术时间。术后早期化疗有助于杀灭残存肿瘤细胞,提高生存期。
Objective To evaluate the role of neoadjuvant bilateral anterior cerebral artery occlusion with chemoembolization in the treatment of advanced epithelial ovarian cancer. Methods From May 1994 to June 2004, 119 patients with advanced ovarian epithelial carcinoma of Tianjin Medical University General Hospital were divided into 3 groups. Among them, the study group was treated with superselective bilateral internal iliac artery before chemotherapy and embolization plus tumor cytoreductive Surgery + adjuvant chemotherapy. The control group 1 was treated with cytoreductive surgery + adjuvant chemotherapy on the day before surgery. The control group 2 was treated with cytoreductive surgery + adjuvant chemotherapy on the 3rd day after the operation. The success rate of cytoreductive surgery, intraoperative blood loss, operation time and survival rate of ideal tumor cells in each group were compared. Results The tumor volume of the study group decreased to some extent. The success rate of the ideal cytoreductive surgery was significantly higher than that of the control group 1 and group 2 (71.43%: 48.84%: 50%), and the blood loss and operation time were significantly higher than those of the control group Reduce and shorten. The overall average survival time of the study group was 26 months, and the mean disease-free survival time was 18.2 months. There was no significant difference compared with the control group 1, which was statistically significant compared with the control group 2. Conclusions Auxiliary bilateral anterior cerebral artery occlusion with chemoembolization can effectively improve the success rate of surgical cytoreductive surgery for advanced ovarian epithelial carcinoma, reduce the difficulty of operation, reduce intraoperative bleeding and shorten the operation time. Early postoperative chemotherapy helps to kill the remaining tumor cells and improve survival.