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舌动脉超选择插管化学治疗栓塞治疗中晚期舌癌的临床疗效观察

Clinical efficacy of super-selective lingual arterial transcatheter chemoembolization in treating moderate and advanced tongue cancer
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摘要 目的:探讨舌动脉超选择插管化学治疗栓塞在中晚期舌癌治疗中的价值。方法对11例临床 TNM分期为 T2~T4的舌鳞癌患者,从右股动脉超选择插管至舌动脉注入顺铂120 mg、盐酸博安霉素50 mg 及少量明胶海绵颗粒,3~4周后行手术切除,手术后行 DT 50 Gy 放射治疗。结果栓塞术后10 d 后,肿瘤均开始出现不同程度的缩小。术后出现中低度发热3例,轻度恶心4例,轻度呕吐1例。未发现骨髓抑制及肝肾功能损害等全身不良反应。根治性手术前评估肿瘤完全缓解2例,部分缓解9例,有效率100%;术中肿瘤均能完全切除,术后病理切片显示肿瘤组织内有明显坏死灶。术后随访1年,11例舌癌患者均未发现肿瘤复发或转移。结论对中晚期舌癌行舌动脉超选择插管化学治疗栓塞临床疗效好,不良反应少。 Objective To investigate the value of super-selective lingual arterial transcatheter chemo-embolization in the treatment of moderate and advanced tongue carcinoma.Methods Eleven patients were di-agnosed with T2 ~T4 tongue squamous cell cancer according to TNM staging.All patients were injected with cisplatin 120 mg,boanmycin hydrochloride 50 mg and a slight amount of gelatin sponge particles via super-se-lective catheterization from the lingual artery to the right femoral artery.Radical resection was performed 3 ~4 weeks later.Radiotherapy at a dosage of DT 50 Gy was conducted following surgery.Results At 10 d after chemoembolization,the tumor size was reduced to varying extent.Postoperatively,3 cases had mild and moder-ate fever,four with mild nausea and one with slight vomiting.No bone marrow suppression,hepatic and renal function injuries or alternative systemic adverse events were noted.Tumor evaluation before radical resection re-vealed that two patients had complete remission and nine partial remission with an effective rate of 100%.All tumors were completely resected intraoperatively.Postoperative pathological examination demonstrated that ap-parent necrotic lesions were found in the tumor tissues.Neither tumor recurrence nor metastasis was found after 1-year follow-up.Conclusion Super-selective lingual arterial transcatheter chemoembolization was a safe and effective treatment of moderate and advanced tongue cancer,yielding few adverse events.
出处 《新医学》 2015年第5期324-327,共4页 Journal of New Medicine
关键词 舌癌 动脉插管 化学治疗栓塞 Tongue carcinoma Arterial catheterization Chemoembolization
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