Objective To summarize the blood supply to the sources and characteristics of advanced breast cancer,and explore the method,efficacy,and clinical applications of preoperative super-selective arterial catheterization chemoembolization under DSA for it.
Methods Sixty patients with advanced breast cancer confirmed by the aspiration biopsy from February 2007 to October 2011 in this hospital were selected. Seldinger method was used,distributing of the tumor blood supply artery was identified and intubated the target artery by super-selective arterial catheterization via the femoral artery puncture under the DSA. Then,pirarubicin 60 mg plus paclitaxel 120 mg of two chemotherapy drugs was injected into slowly the target artery and the intervention infusion chemotherapy was performed,finally the tumor blood supply artery was embolizated by gelatin sponge particle.
Results A total of 112 conclusive blood supply artery in 60 patients with DSA were found,including eight cases of single blood supply artery,52 cases of multiple blood supply arteries,mainly in the lateral thoracic artery and (or) internal thoracic artery-based. The complete remission rate was 25.0% (15/60),partial remission rate was 73.3% (44/60),stable disease rate was 1.7% (1/60),the total effective rate was 98.3% (59/60). There was no progression disease. The median remission duration was 19 months,median survival time was 40 months.
Conclusions The location of the original foci of breast cancer is closely related to blood supply arteries. The tumor in the lateral of the breast mainly dominates by the lateral thoracic artery blood supply. The tumor in the inner breast mainly dominates by the internal thoracic artery blood supply. The preoperative super-selective arterial catheterization chemoembolization under DSA can obviously improve the therapeutic effect,long-term survival,and the target of interventional chemoembolization.
Citation:
ZHOU Tao,ZHUANG Yaqiang,XU Biao,QIN Shuting,.. Clinical Analysis of Preoperative Super-Selective Arterial Catheterization Chemoembolization under DSA for Advanced Breast Cancer and Their Characteristics of Blood Supply Artery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(8): 850-855. doi:
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- 1. 张斌, 张强. 可手术乳腺癌的新辅助全身治疗[J]. 中华肿瘤杂志, 2007, 29(3):161-165.
- 2. 王先明, 何劲松, 佟建蒙, 等. 立体超选择动脉灌注化疗在治疗晚期乳腺癌中的临床应用[J]. 外科理论与实践, 2006, 11(2):136-138.
- 3. 黄镜, 张频, 刘鹏, 等. 炎性乳腺癌38例临床报告[J]. 癌症, 2002, 21(8):888-891.
- 4. Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer:findings from National Surgical Adjuvant Breast and Bowel Project B-18[J]. J Clin Oncol, 1997, 15(7):2483-2493.
- 5. 许彪, 庄亚强, 刘惕生, 等. 乳腺癌DSA造影及术前超选择性动脉化疗栓塞[J]. 介入放射学杂志, 2011, 20(9):696-699.
- 6. Feldman F, Habif DV, Fleming RJ, et al. Arteriography of the breast[J]. Radiology, 1967, 89(6):1053-1061.
- 7. Bilbao JI, Rebollo J, Longo JM, et al. Neoadjuvant intra-arterial chemotherapy in inflammatory carcinoma of the breast[J]. Br J Radiol, 1992, 65(771):248-251.
- 8. Doughty JC, McCarter DH, Kane E, et al. Anatomical basis of intra-arterial chemotherapy for patients with locally advanced breast cancer[J]. Br J Surg, 1996, 83(8):1128-1130.
- 9. 周毅, 吴沛宏, 黄金华, 等. 术前动脉灌注化疗治疗乳腺癌的临床研究[J]. 中华实验外科杂志, 2004, 21(5):625-626.
- 10. Vanel D. Interventional radiology:The new daily work of the breast radiologist[J]. Eur J Radiol, 2002, 42(1):1-4.
- 11. 周汝明, 邱水波, 刘闽华, 等. 乳腺癌的血液供应及术前动脉灌注化疗[J]. 中国医学影像技术, 2008, 24(9):1449-1452.
- 12. 汤钊猷. 现代肿瘤学[M]. 第2版. 上海:上海医科大学出版社, 2000:502.
- 13. 牟鹏, 厉红元. 乳腺癌新辅助化疗的研究进展[J]. 中国普外基础与临床杂志, 2011, 18(9):1011-1016.
- 14. 徐有富, 唐川. TEC与CEF方案在乳腺癌术前化疗中的疗效对比研究[J]. 中国普外基础与临床杂志, 2011, 18(8):880-883.
- 15. 杨名添, 王欣. 局部晚期乳腺癌术前动脉内灌注化疗的临床研究[J]. 中国肿瘤临床, 1998, 25(1):23-25.
- 16. 钟柏冰. Ⅰb2~Ⅲb期宫颈癌术前介入化疗的近期疗效观察[J]. 重庆医学, 2009, 38(24):3097-3098.
- 17. 庄兴俊, 欧娟娟, 高云姝, 等. 高强度聚焦超声联合肝动脉介入化疗治疗45例中、晚期肝癌的临床研究[J]. 重庆医学, 2010, 39(1):46-47.
- 18. 张婧娴, 孟祥文. 介入放射学治疗乳腺癌的临床应用与展望[J]. 实用医学影像杂志, 2005, 6(1):55-57.
- 19. 汪志良, 范晔, 曹军, 等. 晚期及术后复发乳腺癌的介入治疗[J]. 介入放射学杂志, 2004, 13(2):147-149.
- 20. 陈义雄, 梁立华, 周国英, 等. 乳腺癌锁骨下动脉造影与灌注化疗的疗效观察[J]. 中国临床医学影像杂志, 1998, 6(4):65-66.
- 21. 刘光元, 曹建明, 陈自谦. 肿瘤血管介入治疗[M]. 南京:江苏科学技术出版社, 2003:94-97.