Ⅰb～Ⅱb期高危型宫颈癌术前同步放化疗治疗中不同化疗途径的疗效比较

Preoperative con current radiotherapy and chemotherapy for stage Ⅰb～Ⅱb high-risk cervical carcinoma.

目的观察Ⅰb～Ⅱb期高危型宫颈癌(巨块型、分化差、非鳞癌)术前同步放化疗治疗中不同化疗途径的疗效及不良反应。方法回顾性分析2003年1月～2009年12月我院收治的74例同步放化疗治疗的Ⅰb～Ⅱb期高危型子宫颈癌患者的临床病理资料,根据化疗途径的不同分为两组,动脉化疗(动脉化疗组)38例及静脉化疗(静脉化疗组)36例,并对两组的不良反应和疗效进行比较。结果动脉化疗组中,化疗有效率为82%。静脉化疗组中,化疗有效率为81%。两组比较差异均无统计学意义(P>0.05)。化疗期间未发现不能耐受的不良反应。动脉化疗组3年盆腔复发率、5年生存率分别为7.9%、70%;静脉化疗组3年盆腔复发率、5年生存率分别7.8%、71%,两组分别比较差异均无统计学意义(P>0.05)。结论同步放化疗对Ⅰb～Ⅱb期高危型子宫颈癌治疗是安全有效的。相对介入动脉化疗,静脉化疗使用简便、经济,无需特殊设备,在经济条件较差的地区值得推广。

Objective Observed Ⅰb～Ⅱb of high-risk cervical cancer（bulky,poorly differentiated,non-squamous cell cancer）Preoperative concurrent radiotherapy and chemotherapy in different ways chemotherapy efficacy and toxicicty.Methods A retrospective analysis from January 2003 to December 2009 in Guang′an City People′s Hospital admitted 74 patients with concurrent radiotherapy and chemotherapy of Ⅰb～Ⅱb cervical cancer patients of high risk clinical and pathological data,according to the different ways chemotherapy is divided into two groups,arterial infusion chemotherapy（artery chemotherapy group） 38 cases and intravenous chemotherapy（intravenous chemotherapy group）36 cases,and toxicity of the two groups and the effects were compared.Results In the artery chemotherapy group,the effective rate was 82%.While in the venous chemotherapy group,the effective rate was 81%.The differences between these two groups showed no significance（P0.05）.No intolerable toxic and adverse effects were noticed during concurrent radiotherapy and chemotherapy.The 3-year pelvic recurrence rate and 5-year survival rates of arterial interventional chemotherapy group were 76%,70% respectively,and those of venous chemotherapy group were 7.8%,71% respectively,without significant difference（P0.05）.Conclusion Concurrent radiotherapy and chemotherapy is a safe and effective means for treating patients with Ⅰb～Ⅱb of high-risk cervical cancer.The therapeutical effects of venous and arterial interventional chemotherapy are similar.Venous administration is easy and inexpensive and less demanding for special equipments.It shows promising prospect in clinical application especially in the area with poor economic conditions.