НЕОАДЪЮВАНТНАЯ КОМБИНИРОВАННАЯ ХИМИОТЕРАПИЯ У БОЛЬНОЙ РАКОМ ШЕЙКИ МАТКИ IIIB СТАДИИ С ИСПОЛЬЗОВАНИЕМ ВНУТРИАРТЕРИАЛЬНОГО ВВЕДЕНИЯ ПРЕПАРАТОВ ПЛАТИНЫ

А. A. Рерберг, А. А. Костин, А. А. Бойко, Е. А. Новикова, Н. Волченко, О. A. Чулкова, Л. A. Демидова, Г. A. Хохриков, Д. Сидоров, А. Геворкян
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引用次数: 1

Abstract

The main treatment for cervical cancer are surgery, radiation and combined (surgery + radiotherapy), the role of chemotherapy in this localization is studied less fully. In recent years the new possibilities of chemotherapy, including neoadjuvant intraarterial chemotherapy, are explored. Theoretical prerequisites for this are the best drug delivery to the tumor by blood vessels, undamaged due to radiation therapy and surgery. This paper describes a clinical case of a patient with primary inoperable cervical cancer. As an alternative to preoperativ e radiotherapy the patient was proposed neoadjuv ant com bination chemotherapy with the use of regional administration of platinum drugs and systemic administration of drugs of taxan series as a stage of preparation for further surgical treatment. According to the prevalence of the tumor process patient underwent 2 courses of neoadjuv ant chemotherapy by a method of superselective intra-arterial administration of cisplatin and paclitaxel intravenously. According to a comprehensive examination after treatment data for the presence of tumor was absent. During the second stage the patient underwent surgical treatment in the volume of nerve-sparing radical hysterectomy with appendages. The next step, according to the histological form of the tumor, stage of disease, was the radiotherapy in the postoperative period on the pelv ic area and routes of lym ph drainage. The patient underwent external beam radiotherapy to the pelvic area of FD = 20 Gr, intracavitary gamma-therapy and external beam radiation on the area of parametrial and lymphopenia FD = 50 Gr.The patient passed the control examinations every 3 months. According to a comprehensive survey a year after the start of treatment — there is no data for the presence of recurrence and spread of tumor process.
宫颈癌患者IIIB使用动脉内铂药物进行综合化疗
宫颈癌的主要治疗方法为手术、放疗及手术+放疗联合治疗,化疗在此定位中的作用研究较少。近年来,化疗的新可能性,包括新辅助动脉内化疗,被探索。这一理论的先决条件是最好的药物通过血管输送到肿瘤,不受放射治疗和手术的损害。本文介绍了一例原发性不能手术的宫颈癌患者的临床病例。作为术前放疗的替代方案,建议患者进行新辅助联合化疗,局部给药铂类药物,全身给药紫杉系列药物,为进一步手术治疗做准备。根据肿瘤进展情况,患者采用顺铂+紫杉醇动脉超选择性给药方式进行2个疗程的新辅助化疗。经综合检查治疗后无肿瘤存在的资料。在第二阶段,患者接受了保留神经的根治性子宫切除术。下一步,根据肿瘤的组织学形态、疾病分期,在术后对盆腔区及淋巴液引流路径进行放疗。患者行盆腔外束放疗FD = 20 Gr,腔内伽玛治疗和参数区及淋巴细胞减少区外束放疗FD = 50 Gr。患者每3个月进行一次对照检查。根据治疗开始一年后的综合调查-没有数据显示存在复发和肿瘤扩散的过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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