Ⅰb-Ⅱb期宫颈鳞癌新辅助化疗

Neoadjuvant Chemotherapy in Stage Ⅰb-Ⅱb Squamous Carcinoma of Uterine Cervix

目的 探讨新辅助化疗对宫颈鳞癌治疗的疗效。方法 实验分为研究组和对照组 ,研究组 4 6例Ⅰb -Ⅱb期宫颈鳞癌给予羟基喜树碱、顺铂、博莱霉素化疗 1～ 2个疗程 ,随后进行根治性手术 ,对照组为 32例宫颈鳞癌患者直接给予根治性手术。通过观察研究组患者病灶大小改变、术后病理反应 ,及两组的术后病理特征、无瘤生存期的长短来评价新辅助化疗在Ⅰb -Ⅱb期宫颈鳞癌治疗中的作用 ,同时观察化疗的毒副作用发生情况以评价化疗的安全性。结果 化疗组临床有效为 36例 (78 3% ) ,其中完全缓解 8例 ,病理证实的完全缓解为 6例 ;化疗组与未化疗组淋巴结转移发生率分别为 (4 /4 6 ) 8 7%、(6 /32 ) 18 7% ,差异无显著性P =0 30 2 ;化疗组无化疗相关死亡患者。结论 HDB方案有效、低毒、易控 ,采用该方案在宫颈癌根治术前进行新辅助化疗对Ⅰb -Ⅱb宫颈鳞癌治疗具有较高疗效 。

Objective To determine the role of neoadjuvant chemotherapy (NAC) in cervix cancer.Methods 46 patients with squamous carcinoma of the uterine cervix,stage Ⅰb-Ⅱb,as study group,were treated with one or two cycles of cisplatin combined with hydroxycamptothecine-bleomycin regimen,followed by radical surgery;32 patients as control group were directly treated with radical surgery.Response and toxicity in study group were observed to evaluate the effect and security of NAC in the treatment of stage Ⅰb-Ⅱb squamons carcindma of uterine cervix.Results A total of 36 cases clinical response(78.3%) were recorded,8 cases complete remission,and in which 6 cases were microscopic pathological response.Lymph node metastasis in pelvic of study group and control group were (4/46) 8.7%-(6/32) 18.7% respectively,but significant difference were not observed(P=0.302).No patient died of disease concerned with NAC.Conclusion NAC with HDB combination was low-toxicity-controllable-effective in the treatment of stage Ⅰb-Ⅱb squamous carcinoma of uterine cervix,and the treatment followed by radical surgery can improve the survival term.