顺铂联合表阿霉素对子宫颈癌介入化疗价值的评估

Clinical efficacy of the interventional chemotherapy with cisplatin combined epirubicin for locally advanced cervical cancer

目的：探讨顺铂（DDP）联合表阿霉素（E-ADM）对子宫颈癌术前介入化疗的临床价值。方法：对54例中位年龄为41．6岁（30～70岁）ⅠB2期-Ⅲ期巨块型子宫颈癌病例，行DDP＋E-ADM髂内动脉介入化疗，再行手术或放疗，介入化疗的近期疗效、对手术的影响、毒副反应，并作进一步随访以观察远期疗效。结果：经1～3个疗程介入化疗，总有效率为94．4％。病理切片检查示肿瘤细胞大量坏死及退变，7．4％的病例可见肿瘤细胞消失；未见严重毒副反应。51例赢得手术切除机会，术中见宫颈癌灶缩小、肿瘤组织疏松易分离，手术难度降低，肿瘤组织更易清除。5年以上存活率达93．3％，复发率和死亡率均为4％。结论：顺铂联合表阿霉素用于子宫颈癌术前介入化疗，可明显缩小病灶、提高手术的顺应性，使晚期或巨块型肿瘤年轻患者获得手术清除病灶的机会；其近期疗效好，毒副作用小，复发率低，术后存活率高，值得临床进一步研究应用。

Objective ：To investigate the clinical efficacy of a neoadjuvant chemotherapy for locally advanced cervical cancer. Methods-A total of 54 patients with stage I B2-HI of locally advanced cervical cancer were treated with the interventional chemotherapy with cisplatin combined with epirubicin followed by a radical hysterectomy or a radiotherapy, then the effects of this chemotherapy on the operation and on the overall effective rate and survival rate were analysed according to clinical evaluation and follow-up. Results. After 1-3 cycles of interventional chemotherapy, the total response rate of this chemotherapy was 94. 4% , including 29.6% complete and 64. 8% partial response. According to histopathology examination, cancer cells significantly necrosed and degenerated, and even disappeared in 7.4%. Fifty-one cases gained the operation opportunity. In these cases, it was confirmed that tumor focus reduced and the tumor tissue was looser and eased to be isolated and removed in the operation. Accoding to data of follow-up, the 5-year survival rate was 93.3%, recurrent rate and death rate was 4%. The serious toxicity and side-effects of this therapy were not observed. Con- dusion：The neoadjuvant interventional chemotherapy with cisplatin combined epirubicin for locally advanced cervical cancer reduces tumor focus and recurrent occurrence, increases opportunity of radical hysterectomy and survival, while has moderate toxic reaction and side reaction. It is a good choice in clinic.