两种治疗方案对巨块型宫颈癌的近期疗效对比

Comparison of recent effect between two kinds of neo-adjuvant chemotherapy in massive cervical cancer

目的:比较两种新辅助化疗方法对Ⅰb2～Ⅱb期宫颈癌的近期疗效。方法:进行新辅助化疗的Ⅰb2～Ⅱb期宫颈癌患者78例,对患者的临床病理资料进行回顾性分析,其中经静脉全身化疗者41例(静脉组),经子宫动脉插管化疗者37例(动脉组)。结果:静脉组患者经新辅助化疗后总有效率为85%(35/41),动脉组为92%(34/37),两组差异无统计学意义(P>0.05)。两组患者新辅助化疗后手术时间、出血量和并发症发生率比较,差异无统计学意义(P>0.05)。Ⅱb期患者经新辅助化疗后手术,术后病理检查发现盆腔淋巴结转移率无统计学差异(P>0.05),宫旁浸润率两组比较动脉组发生率低于静脉组(P=0.03)。结论:两种途径的新辅助化疗有效率和手术难度相当,子宫动脉介入化疗对改善宫旁浸润效果更好。

Objective：To compare the recent effect between intra-arterial and intra-venous neoadjuvant chemotherapy（NACT） in stageⅠb2-Ⅱb cervical cancer. Methods：A retrospective analysis was done on 41 cases of intra-venous NACT and 37 eases of intra-arterial NACT for stage I b2-Ⅱb cervical cancer. Results：The effective rate of intra-venous NACT and intra-arterial NACT was 85%（37/41） and 92%（35/37） respectively（P0.05）.There were no significant differences in surgery time,blood loss and post-operative morbidity between these two groups.There were no significant differences in lymph node metastasis rate between these two groups（P0.05）.Pathological parametrial positive rate after NACT in arterial group（8.3%）was significantly lower than that of venous group（50%）（P0.05）. Conclusion：Effective rate,operative rate and surgical difficulties are similar between the intra-arterial and intra-venous NACT for stage I b2-Ⅱb cervical cancer.Arterial NACT show better effect on parametrical infiltration.