两种新辅助化疗治疗Ⅱ_B期宫颈癌近期疗效的比较

Comparison of the recent effects of two neoadjuvant chemotherapies for stageⅡ_B cervical cancer

目的:比较两种新辅助化疗治疗ⅡB期宫颈癌的近期疗效及毒副反应。方法:回顾性分析我院2003年10月至2007年3月治疗的83例ⅡB期宫颈癌患者的临床资料,根据化疗途径分为两组,动脉灌注介入化疗组(49例)和静脉全身化疗组(34例)。比较两组化疗疗效及手术率、毒副反应、手术出血量、术后病理情况。结果:介入化疗组手术率61.2%。静脉化疗组手术率64.7%,两种方法无明显差异(P>0.05)。术中出血量介入化疗组(369±96.96)ml,静脉化疗组(461±140.21)ml,统计学上有显著差异(P<0.05)。介入化疗组术后病理盆腔淋巴转移占33.3%,静脉化疗组术后病理盆腔淋巴转移占18.1%,统计学上无显著差异(P>0.05)。常见的化疗毒副反应两组无显著差异(P>0.05)。盆腔疼痛是介入治疗中较常见出现的,静脉化疗组无盆腔疼痛者。术后3年生存率动脉介入组81.63%,静脉化疗组75%(P>0.05)。结论:两种新辅助化疗治疗ⅡB期宫颈癌的近期疗效均较好,副反应较轻。介入化疗有更好的止血效果,静脉化疗经济简便。两种新辅助化疗均有临床应用价值。

Objective：To compare the recent effects and adverse reactions of two neoadjuvant chemotherapies for stage Ⅱ B cervical cancer. Methods ： Clinical data of 83 in - patients with stage Ⅱ B cervical cancer in our hospital from October 2003 to March 2007 were analysed retrospectively, which were divided into two groups according to chemotherapy methods：arterial infusion chemotherapy group （49 eases） and intravenous chemotherapy group （34 eases ）. The chemotherapy effects, operation rates, adverse reactions, operation bleeding volume and postoperative pathology were compared. Results： The operation rate of arterial infusion chemotherapy group and intravenous systemic chemotherapy group were 61.2% and 64.7 % respectively, which was no statistically significant difference （ P 〉 0.05）. The bleeding volume in operation was （369 ±96.96） ml and （461±140.21 ）ml respectively, which was statistically significant different （P 〈 0.05 ）. The rates of pelvic lymph node metastasis of two groups were 33.3% and 18.1% respectively, which was no statistically significant difference（ P 〉 0.05 ）. There was no significantly difference in adverse reactions of two groups. Pelvic pain was more common in infusion chemotherapy group and there was no case with pelvic pain in intravenous systemic chemotherapy＇group. The 3 - year survival rates after surgery of arterial interventional chemotherapy group were 81.63% , and those of venous chemotherapy group was 75% , without significant difference （ P 〉 0.05 ）. Conclusion： Recent effect of two neoadjuvant chemotherapy was satisfactory and adverse reactions was minor. There was better hemostatie effect in infusion chemotherapy group, however, intravenous chemotherapy was more simple and economic methods. Both neoadjuvant ehemotherapie had clinical value.