目的 评价CalliSpheres载药微球子宫动脉栓塞术治疗局部晚期宫颈癌疗效。 方法 选取2016年2月至2018年9月本介入科收治的宫颈癌患者48例（平均年龄49岁），采用随机数字分配法将患者分为普通微球子宫动脉栓塞+表阿霉素子宫动脉灌注化疗组24例（A组），表阿霉素载药微球子宫动脉栓塞化疗组24例（B组）。每组治疗2个周期，间隔3周。记录出血减少情况，以CT评价肿瘤大小变化，分析骨髓抑制及消化道反应。 结果 （1）两组患者阴道出血均减少；普通微球组术后出血持续时间为（6±1.5）d，载药微球组为（3± 0.8）d，差异有统计学意义，P<0.01。（2）肿瘤缩小率：普通微球组客观缓解率为83.8%，载药微球组为95.8%，差异有统计学意义，P<0.01。（3）副反应：两组患者均出现腹痛，VAS评分普通微球组（8±2）分，载药微球组（3±1）分，差异有统计学意义，P<0.01；骨髓抑制仅发生于普通微球组。 结论 CalliSpheres载药微球治疗宫颈癌较传统的化疗栓塞术具有更高的肿瘤缩小率，术后阴道出血时间更短，无骨髓抑制且腹痛可控。
Abstract
Objective To evaluate the efficacy of CalliSpheres drug-loaded microsphere uterine artery embolization in the treatment of locally advanced cervical cancer. Methods Forty-eight patients (average age was 49 years old) with cervical cancer admitted to our department from February 2016 to September 2018 were randomly divided into two groups: normal microsphere uterine artery embolization + 24 cases of epirubicin uterine arterial infusion chemotherapy (group A); 24 cases of drug-loaded microspheres (epimycin) uterine artery chemoembolization (group B). Each group was treated with the same procedures three weeks apart, total two times. The reduction in bleeding was recorded, and tumor size changes were evaluated by CT, and bone marrow suppression and digestive tract reactions were analyzed. Results (1) Both groups of patients had reduced vaginal bleeding. The duration of postoperative bleeding in the conventional microsphere group was (6±1.5) days, and that in the drug-loaded microsphere group was (3±0.8) days, the difference was statistically significant (P<0.01). (2) Tumor reduction rate: The objective remission rate of the ordinary microsphere group was 83.8%, and that of the drug-loaded microsphere group was 95.8%. The difference was statistically significant (P<0.01). (3) Abdominal pain occurred in both groups. The VAS score of the general microsphere group was (8±2), and the VAS score of the drug-loaded microsphere group was (3±1). There were statistical difference in the VAS score (P<0.01). Myelosuppression occured only in the normal microsphere group. Conclusions CalliSpheres drug-loaded microspheres have higher tumor shrinkage rate for cervical cancer, shorter postoperative vaginal bleeding, no bone marrow suppression and controllable abdominal pain.
关键词
宫颈癌 /
化疗栓塞 /
栓塞微球 /
CalliSpheres微球
Key words
Cervical cancer /
Chemoembolization /
Embolization microspheres /
CalliSpheres beads
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参考文献
[1] 周晖, 刘昀昀, 罗铭, 等. 2020 NCCN子宫颈癌临床实践指南(第1版)解读[J]. 中国实用妇科与产科杂志, 2020, 36(2): 131-138. DOI: 10.19538/j.fk2020020111.
[2] 刘伏香, 李华淑, 莫朝霞. 术前介入治疗对ⅠB_2~ⅡB期宫颈癌的疗效分析[J]. 中国肿瘤临床, 2008, 35(20): 1165-1167+1174. DOI: 10.3969/j.issn.1000-8179.2008.20.007.
[3] 柯要军, 王强, 张杰, 等. 动脉化疗栓塞与动脉灌注化疗对进展期宫颈癌的疗效观察[J]. 实用癌症杂志, 2015, 30(5): 685-687. DOI: 10.3969/j.issn.1001-5930.2015.05.017.
[4] Serkies K, Jassem J. Systemic therapy for cervical carcinoma - current status[J]. Chin J Cancer Res, 2018, 30(2): 209-221. DOI: 10.21147/j.issn.1000-9604.2018.02.04.
[5] 兰丽. 子宫动脉灌注化疗栓塞术在宫颈癌治疗中的应用[J]. 世界最新医学信息文摘, 2018, 18(22): 131, 135. CNKI: SUN:WMIA.0.2018-22-078.
[6] 潘静, 姚丽艳, 朱晓玉, 等. 中晚期宫颈癌动脉灌注化疗临床疗效分析[J]. 中国现代手术学杂志, 2018, 22(1): 56-60. DOI: 10.16260/j.cnki.1009-2188.2018.01.015.
[7] Guan YS, He Q, Jin Y, et al. [Development of CalliSpheres® embolic microspheres][J]. Zhonghua Gan Zang Bing Za Zhi, 2016, 24(7): 549-551. DOI: 10.3760/cma.j.issn.1007-3418.2016.07.016.
[8] Zhou GH, Han J, Sun JH, et al. Efficacy and safety profile of drug-eluting beads transarterial chemoembolization by CalliSpheres® beads in Chinese hepatocellular carcinoma patients[J]. BMC Cancer, 2018, 18(1): 644. DOI: 10.1186/s12885-018-4566-4.
[9] Wu BL, Zhou J, Ling GH, et al. CalliSpheres drug-eluting beads versus lipiodol transarterial chemoembolization in the treatment of hepatocellular carcinoma: a short-term efficacy and safety study[J]. World J Surg Oncol, 2018, 16(1): 69. DOI: 10.1186/s12957-018-1368-8.
[10]Micheletti E, La Face B, Bianchi E, et al. Continuous infusion of carboplatin during conventional radiotherapy treatment in advanced squamous carcinoma of the cervix uteri IIB-IIIB (UICC). A phase I/II and pharmacokinetic study[J]. Am J Clin Oncol, 1997, 20(6): 613-620. DOI: 10.1097/00000421-199712000-00017.
[11]李秀云, 王玉芝, 姚海燕, 等. 化疗毒性反应标准的可行性验证[J]. 前卫医药杂志, 1998, 15(5): 3-5.
[12]Guo ZW, Meng C, Wei X, et al. Combination nivolumab with transcatheter arterial chemoembolization for clinical remission of small cell lung cancer: a case report[J]. Thorac Cancer, 2018, 9(5): 646-651. DOI: 10.1111/1759-7714.12600.
[13]Zhou DS, Liang JZ, Xu L, et al. Derived neutrophil to lymphocyte ratio predicts prognosis for patients with HBV-associated hepatocellular carcinoma following transarterial chemoembolization[J]. Oncol Lett, 2016, 11(5): 2987-2994. DOI: 10.3892/ol.2016.4359.
[14]Yarmohammadi H, Gonzalez-Aguirre AJ, Maybody M, et al. Evaluation of the effect of operator experience on outcome of hepatic artery embolization of hepatocellular carcinoma in a tertiary cancer center[J]. Acad Radiol, 2018, 25(7): 856-860. DOI: 10.1016/j.acra.2017.12.011.
[15]Tian ZZ, Li S, Wang Y, et al. Investigation of uterine arterial chemoembolization and uterine arterial infusion chemotherapy for advanced cervical cancer before radical radiotherapy: a long-term follow-up study[J]. Arch Gynecol Obstet, 2014, 290(1): 155-162. DOI: 10.1007/s00404-014-3166-z.
[16]Ikeda O, Mizukami N, Murata Y, et al. Randomized comparison of intra-arterial chemotherapy versus intra-arterial chemotherapy and gelfoam embolization for treatment of advanced cervical carcinoma[J]. Cardiovasc Intervent Radiol, 2005, 28(6): 736-743. DOI: 10.1007/s00270-004-4178-z.
基金
燕山大学亚稳材料制备技术与科学重点实验室开放课题（202101）；国家自然科学基金（81100479）；河北省自然科学基金（C2021202002）；天津市自然科学基金（20JCYBJC00470）；2020年度领航精英专项科研基金（XM2020031029501）
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