Wang Xiaoyi, Gan Changing, Li Hongyuan, Wei Yuxian, Zhu Donchang, Yang Guanglun, Su Xinliang, Rodier Jean-François, Ren Guosheng
Department of Breast and Endocrine Surgery, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, P.R. China ;
Department of Surgical Oncology, Paul Strauss Cancer Center, 67065 Strasbourg, France.
Mol Clin Oncol. 2013 Jul;1(4):745-748. doi: 10.3892/mco.2013.129. Epub 2013 May 23.
Intra-arterial infusion chemotherapy for locally advanced breast cancer (LABC) has been previously performed. However, the main complications of this type of chemotherapy remain to be clarified. In the present study, catheterization chemotherapy was carried out for 53 LABC cases (stage IIIa-IIIc) between May, 2006 and March, 2007. For IIIB and IIIC patients, the catheters were guided to the opening of the subclavian artery. For stage IIIa patients, the catheters were placed into the thoracic artery through a subcutaneous femoral artery puncture. One to four cycles of chemotherapy (mean, 1.6 cycles) were administered for the patients using taxotere, epidoxorubicin, 5-fluorouracil and/or cyclophosphamide. The interval time between the two cycles was 21 days. Seven cases were identified as complete response (CR, 13.2%), 41 cases were partial response (PR, 77.4%) with a rate of effectiveness of (CR + PR, 90.6%), 5 cases were stable disease (SD, 9.40%) and no case was progressive. Pain of the ipsilateral upper extremity was present in 7 cases. Two cases exhibited ipsilateral upper extremity atrophy following drug administration from the opening of the subclavian artery. One case experienced neck pain and headache, while in one case necrosis of local skin was evident. Hematological toxicity over grade 3 was observed in 6 cases (11.30%). Systemic toxicity was mild and did not affect the quality of life of the patients. Overall survival was identified as 18/51 (35.3%), and free-disease survival as 10/51 (19.6%). In conclusion, intra-arterial infusion chemotherapy is an effective local control treatment for LABC. The main complications are pain of the ipsilateral upper extremity and neck as well as headache. Severe complications are ipsilateral upper extremity atrophy and necrosis of local skin. During the treatment, controlling the pressure of the tourniquet and velocity of drug administration are crucial for reducing local complications.
动脉内灌注化疗已用于局部晚期乳腺癌（LABC）的治疗。然而，这类化疗的主要并发症仍有待阐明。在本研究中，于2006年5月至2007年3月期间，对53例LABC患者（IIIa - IIIc期）实施了导管化疗。对于IIIB和IIIC期患者，将导管引导至锁骨下动脉开口处。对于IIIa期患者，通过股动脉皮下穿刺将导管置入胸动脉。使用多西他赛、表柔比星、5 - 氟尿嘧啶和/或环磷酰胺对患者进行1至4个周期的化疗（平均1.6个周期）。两个周期之间的间隔时间为21天。7例患者达到完全缓解（CR，13.2%），41例患者部分缓解（PR，77.4%），有效率为（CR + PR，90.6%），5例患者病情稳定（SD，9.40%），无病例病情进展。7例患者出现同侧上肢疼痛。2例患者从锁骨下动脉开口给药后出现同侧上肢萎缩。1例患者出现颈部疼痛和头痛，1例患者局部皮肤坏死明显。6例患者（11.30%）观察到3级以上血液学毒性。全身毒性较轻，未影响患者生活质量。总生存率为18/51（35.3%），无病生存率为10/51（19.6%）。总之，动脉内灌注化疗是治疗LABC的一种有效的局部控制方法。主要并发症为同侧上肢和颈部疼痛以及头痛。严重并发症为同侧上肢萎缩和局部皮肤坏死。治疗期间，控制止血带压力和给药速度对于减少局部并发症至关重要。
