术前同期放化疗对局部晚期宫颈癌近期疗效的综合评价

The evaluation of effectiveness of concurrent chemoradiation for locally advanced cervical cancer

目的观察奈达铂、替加氟新辅助化疗联合腔内后装放疗，同期治疗局部晚期宫颈癌（LACC）临床疗效。方法回顾性分析了81例LACC患者，分为三组，分别于术前接受奈达铂＋替加氟新辅助化疗（NACT）、单纯腔内后装放射治疗（CLI）、新辅助化疗联合后装放疗（CCR），比较不同的治疗方法对手术疗效的影响。结果CCR组对宫颈局部肿瘤的治疗有效率（CR＋PR）为88．9％，明显高于NACT组（70．4％，X^2=7．85，P〈0．01）及CLI组（63．0％，X^2=10．71，P〈0．01）。CLI组（25．9％）白细胞下降较NACT（81．5％，X^2=16．76，P〈0．01）及CCR（88．9％，X2=21．89，P〈0．01）组明显减轻。宫旁脉管癌栓发生与盆腔淋巴结转移及宫旁浸润发生率三组相比无统计学差异。结论新辅助化疗联合腔内后装治疗，有望成为局部晚期宫颈癌最佳的术前治疗方案。

Objective To evaluate curative effect of locally advanced cervical cancer （LACC）treated with neoadjuvant chemotherapy and cervical locally irradiation concurrent（CCR）. Methods All the cases were separated into three groups, nedaplatin and isophosphamide neoadjuvant chemotherapy （NACT）, cervical locally irradiation （CLI）, and CCR for evaluating curative effect. Results High effective rate evaluating by CR ＋ PR was observed in CCR compared with NACT and CLI（ 88.9% vs 70.4% ,63.0% ） , and low side effect occurred in CLI compared with NACT and CCR（25.9% vs 81.5% ,85.9% ）. There were no difference in these three groups in lymph node metastase and infiltration of the factors. Conclusion Strong evidence suggested that CCR may be a better choice for LACC.