术前介入化疗对Ⅰb2～Ⅱa期巨块型宫颈癌根治术的影响

Effect of interventional chemotherapy before operation on short-term clinical outcome of radical operation of Ⅰb2-Ⅱa stage massive cervical carcinoma

目的探讨术前介入化疗对Ⅰb2～Ⅱa期巨块型宫颈癌的近期疗效。方法将65例Ⅰb2～Ⅱa期巨块型宫颈癌患者随机分为2组:介入组33例术前予以介入化疗(表阿霉素40～80mg,顺铂40～80mg,5-氟脲嘧啶0.75～1.0g,丝裂霉素10～20mg),介入治疗后3周进行宫颈癌根治术;对照组32例直接行常规宫颈癌根治术。结果介入组介入治疗后肿瘤退缩明显,介入前、后肿瘤直径分别为(4.79±0.93)、(2.98±1.18)cm,缩小(1.81±1.21)cm,缩小百分比达(37.38±24.35)%,介入前、后肿瘤大小差异有统计学意义(P<0.05)。术后介入组宫旁浸润、阴道残端浸润及脉管癌栓发生率均较对照组低(P均<0.05)。结论Ⅰb2～Ⅱa巨块型宫颈癌根治术前介入化疗有一定近期疗效。

Objective To explore the short-term effectiveness of intraarterial interventional chemotherapy for Ib2-Ⅱa massive uterine cervical carcinoma before operation.Methods All 65 patients with bulky uterine cervical carcinoma were randomized divided into intervention group（33 cases）and control group（32 cases）.Thirty three patients in intervention group were treated with interventional chemotherapy before operation including 40-80 mg epidoxorubicina,40-80 mg cisplatin,0.75-1.0 g 5-FU and 10-20 mg mitomycin.The radical operation of cervical carcinoma was taken in three weeks after intraarterial chemotherapy.Thirty two patients in control group were directly treated with radical operation of cervical carcinoma.Results The average diameters of tumor before and after interventional chemotherapy were（4.79±0.93）and（2.98±1.18）cm respectively,and their difference was statistically obvious（P0.05）.The incidence rates of parametrial infiltration,vagina stump infiltration and intravascular cancer embolus after operation in chemotherapy group were lower than those in control group（all P0.05）.Conclusions The intraarterial chemotherapy can decrease the size of local tumor,improve the condition of operation,reduce the cancer cell activity,and its short-term outcome is very good.