Quinn S F, Frau D M, Saff G N, Kavanagh J, Roberts W, Cavanagh D, Clark R A
Department of Diagnostic Imaging, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33682-0179.
Radiology. 1988 Apr;167(1):55-7. doi: 10.1148/radiology.167.1.3347746.
In three patients neurologic complications developed after chemoembolization procedures were performed with cisplatin and a new collagen material. Three patients with dominant unilateral stage III cervical carcinoma were entered into an investigative protocol attempting to control regional disease and pain with chemoembolization. All three patients had previously undergone surgery, radiation therapy, and intraarterial chemoembolization or chemoinfusion. Each case was complicated by neurologic deficits. A collagen material was administered that acts at a precapillary level and reduces the likelihood of collateral flow. The size of the material enables it to embolize the small feeding vessels of the spinal cord and peripheral nerves. The patients in this study also had predisposing factors to neurologic sequelae including the previous therapy and the contributing neurotoxicity of cisplatin. The neurologic complications in these patients are not easily explained by knowledge of the neurovascular anatomy. Even with meticulous technique, intraarterial chemoembolization of the pelvis with cisplatin and collagen can be complicated by serious neurologic deficits.
在用顺铂和一种新型胶原材料进行化疗栓塞手术后,有3例患者出现了神经并发症。3例单侧优势型III期宫颈癌患者进入了一项研究方案,试图通过化疗栓塞来控制局部疾病和疼痛。所有3例患者此前均接受过手术、放疗以及动脉内化疗栓塞或化疗灌注。每例患者均出现了神经功能缺损并发症。使用了一种在毛细血管前水平起作用并降低侧支血流可能性的胶原材料。该材料的大小使其能够栓塞脊髓和周围神经的小供血血管。本研究中的患者也有神经后遗症的易感因素,包括先前的治疗以及顺铂的神经毒性作用。这些患者的神经并发症难以用神经血管解剖知识来解释。即使技术操作精细,用顺铂和胶原进行盆腔动脉内化疗栓塞仍可能并发严重的神经功能缺损。