宫颈癌术前新辅助化疗的临床应用研究

Clinical study of neo-adjuvant chemotherapy before operation in patients with cervical carcinoma

目的:探讨新辅助化疗在子宫颈癌治疗中的价值。方法:研究对象为1991年1月～2003年12月符合入组标准的宫颈癌患者共306例,手术前给予2个疗程联合化疗(即新辅助化疗,A组),选择1988年1月～1990年12月在我院手术前未接受化疗的85例宫颈癌患者作对照(B组),比较两组患者生存率及并发症的发生情况。结果:两组比较5和10年生存率,A组>B组,P=0.045。不同手术方式、有无放化疗及不同病理类型患者5和10年生存率,A组均>B组,P=0.039。5年复发转移率差异有统计学意义,P=0.049。结论:新辅助化疗对适宜手术切除的宫颈癌患者是有益的,能提高近期控制率、手术切除率及远期生存率,减少复发与转移,值得临床推广应用。

OBJECTIVE：To study the value of neoadjuvant chemotherapy in treatment of cervical carcinoma. METHODS： A clinical prospective study was carried out from Jan. 1991 to Dec. 2003,306 patients with cervical carcinoma were given two cycles of combined chemotherapy before operation （neoadjuvant chemotherapy group, group A）. 85 patients accepted surgery alone in our hospital from Jan. 1988 to Dec. 1990 were chosen as the comparison group（group B）. Survival rate and complications were observed and analysed. RESULTS： 5- and 10-year survival rate in group A was significantly higher than that in group B（P= 0. 045）, The 5- and 10-year survival rate was significantly higher in group A than in group B, despite of different surgery styles, with or without radiochemotherapy and different pathological types, P = 0. 039. The recurrent rate was lower in group A than that in group B, which show significantly difference in the 5-year recurrent rate, P = 0. 049. CONCLUSIONS： Neoadjuvant chemotherapy is an effective method for the treatment of cervical carcinoma in early stage. Because of satisfactory short-term control rate, excision rate, long-term survival rate and low recurrent and metastatic rate, neoadiuvant chemotherapy is worth popularizing in clinical treatment.