宫颈癌术前动脉介入化疗栓塞与全身化疗的疗效比较

Comparison of effects of preoperative transcatheter arterial chemoembolization and systemic chemotherapy on tumor resection rate and quality of life in patients with cervical cancer

目的比较分析术前动脉介入化疗栓塞与全身化疗对宫颈癌的疗效和不良反应。方法选取我院自2013年1月至2019年2月收治的宫颈癌患者113例,根据治疗方法不同分成2组,介入组(n=58)术前应用动脉介入化疗栓塞治疗,化疗组(n=55)术前应用全身化疗,两组均进行手术治疗,比较两组患者肿瘤切除率和生存质量。结果介入组化疗后平均手术时间短于化疗组,术中出血量少于化疗组,根治性手术率、淋巴结转移率均优于化疗组,差异均有统计学意义(P<0.05)。两组不良反应主要表现为白细胞和中性粒细胞降低;消化道反应,以恶心、呕吐常见;神经性毒性,主要表现为肌痛、关节痛,均未见明显差异。两组手术后血清VEGF-D、VEGF-C、VEGF-A水平均低于治疗前,差异有统计学意义(P<0.05)。介入组手术后血清VEGF-D、VEGF-C、VEGF-A水平均低于化疗组,差异有统计学意义(P<0.05)。介入组患者术后1年的生存质量总评分与化疗组比较,无统计学差异。结论术前动脉介入化疗栓塞对于宫颈癌疗效明确,可提高根治手术率,降低了肿瘤负荷,减少了亚临床转移,且不良反应与传统化疗相似。

Objective To compare and analyze the effects of preoperative transcatheter arterial chemoembolization and systemic chemotherapy on tumor resection rates and quality of life of patients with cervical cancer.Methods One hundred and thirteen patients with cervical cancer treated in our hospital between January 2013 and February 2019 were divided into two groups according to treatments.The intervention group(n=58)was treated with transcatheter arterial chemoembolization before surgery,while the chemotherapy group(n=55)received systemic chemotherapy preoperatively.The tumor resection rate and quality of life were compared between the two groups.Results The duration of surgery,radical operation rate,intraoperative blood loss and lymph node metastasis rate in the intervention group were significantly different from those of the chemotherapy group(P<0.05).The levels of serum VEGF-D,VEGF-C and VEGF-A in the two groups were lower after operation,and the difference was statistically significant.The levels of serum VEGF-D,VEGF-C and VEGF-A in the intervention group were lower than those of the chemotherapy group after operation,and the difference was also statistically significant.There was no significant difference in the total score of quality of life between the two groups one year after operation(P>0.05).Conclusions Preoperative transcatheter arterial chemoembolization and systemic chemotherapy can significantly improve the tumor resection rate of patients with cervical cancer,and it is an excellent means of chemotherapy.