解放军医学杂志2011，Vol.36Issue(10)：1098-1100,3.
乳腺癌术中化疗泵置入及术后辅助局部灌注化疗的疗效探讨
Therapeutic effects of intraoprative placement of chemotherapy pump and postoperative local infusion of chemotherapeutic drug for breast cancer
奏荣 1蒲永东 1杨波 1阿建苗 1董立国 1曹志宇 1吕刚 1刘卫平 1吴有军1
作者信息
- 1. 100091 北京 解放军309医院普通外科
- 折叠
摘要
Abstract
Objective To observe the effects of postoperative adjuvant local chemotherapy on the prognosis of the patients with breart cancer, and explore the skill of intraoperative placement of a catheter for postoperative chemotherapy duning the operation. Methods Of 102 patients with breast cancer in stage Ⅱ to Ⅲ, 23 were assigned to control group and 79 to catheter and pump-placement group. Quadrantectomy plus axillary lymph node dissection or modified radical mastectomy was performed in both groups, followed by the insertion of a catheter for pumping of chemotherapeutic drug in pump-placement group. The catheter was inserted into axillary artery through the lateral thoracic artery or subscapular artery, connecting with a chemotherapy pump for instillation of chemotherapeutic drug and it was fixed on the skin for local adjuvant chemotherapy thereafter. The catheter was washed with heparin once a week to prevent occlusion. 10-14 days after surgery, patients in pump-placement group underwent local chemotherapy with 5-FU at a dose of 0. 25g once for 4 times up to a total dose of 1. 0g. Routine systematic chemotherapy, radiation and endocrine therapy were given to both groups. Local recurrence was examined during an 18- to 48-month follow-up. Results It took 94-137 (103±14) minutes in control group to perform surgery alone, while it took 105 - 158 (126 ±17) minutes in pump-placement group to perform surgery plus chemotherapy pump placement, in which insertion of the catheter took 15-60 (25±3) minutes. In pump-placement group, exudation in or around the skin at the exit of the catheter occurred in 5 cases (6. 3%), small hematoma in axillary fossa less than 3cm in diameter occurred in 3 cases (3.8%), but there was no limitation of upper extremity movement During follow-up, local recurrence occurred in 2 patients in control group, while no local recurrence in pump-placement group. Conclusions Postoperative local intensified adjuvant chemotherapy may be beneficial in patients with breast cancer with a decrease in recurrence rate. The placement of a chemotherapy pump, though, contributes to prolongation of operation time, but it does not induce severe complications.关键词
乳腺肿瘤/化学疗法,肿瘤,局部灌注/乳房切除术Key words
breast neoplasms/ chemotherapy, cancer, regional perfusion/ mastectomy分类
医药卫生引用本文复制引用
奏荣,蒲永东,杨波,阿建苗,董立国,曹志宇,吕刚,刘卫平,吴有军..乳腺癌术中化疗泵置入及术后辅助局部灌注化疗的疗效探讨[J].解放军医学杂志,2011,36(10):1098-1100,3.
