新辅助化疗治疗局部晚期子宫颈癌的疗效

The Value of neoadjuvant chemotherapy on local advanced cervical cancer

目的探讨新辅助化疗治疗局部晚期宫颈癌的近期疗效。方法将80例局部晚期宫颈癌患者随机分为观察组(新辅助化疗组)和对照组(常规手术组),每组各40例。观察组患者予PBV方案化疗1～2个疗程后进行根治手术,对照组患者直接进行根治手术。比较化疗前后观察组患者肿瘤变化情况及两组患者的术后淋巴结转移、脉管癌栓、宫颈浸润、出血量、手术时间情况及不良反应。结果化疗后观察组患者肿瘤大小明显小于化疗前,差异有统计学意义(P<0.05),化疗后进展1例,稳定8例,部分缓解25例,完全缓解6例,治疗总有效率为77.50%;观察组和对照组患者的手术时间分别为(188.56±32.14)min和(279.28±45.27)min(P<0.05),术中出血量分别为(568.96±206.33)ml和(816.55±229.85)ml(P<0.05),宫颈深层间质浸润发生率分别为57.50%和65.00%(P>0.05),脉管癌栓发生率分别为25.00%和27.50%(P>0.05),淋巴结转移率分别为27.50%和35.00%(P<0.05)。结论新辅助化疗治疗局部晚期宫颈癌能提高近期疗效,减少淋巴结转移率和术中出血量,减少手术时间,减小肿瘤大小。

Objective To discuss the curative effect of neoadjuvant chemotherapy（NACT） on local advanced cervical cancer（LACC）.Methods 80 cases were randomly divided into observation group（NACT） and control group（conventional surgery）.They received 1 to 2 courses of PVB chemotherapy following radical surgery and direct radical surgery respectively.The tumor changes of observation group after chemotherapy and lymphatic metastasis,intravascular cancer emboli,cervical infiltration,amount of bleeding and operation time situation of both groups after operation were compared.The adverse reactions of chemotherapy were recorded.Results After chemotherapy,the tumor size of observation group was obviously smaller than before chemotherapy and the difference was statistically significant（P0.05）.After chemotherapy,1 case deteriorated,8 cases stabilized,25 cases were partly relieved,6 cases were completely relieved,and the total effective rate was 77.50%;the operation time of observation group and control group was respectively（188.56±32.14）min and（279.28±45.27）min（P0.05）,the amount of bleeding during surgery was respectively（568.96±206.33）ml and（816.55±229.85）ml（P0.05）,the occurrence rate of cervical deep stromal infiltration was respectively 57.50%、65.00%（P0.05）,the occurrence rate of intravascular cancer emboli was respectively 25.00%、27.50%（P0.05）,the rate of lymphatic metastasis was respectively 27.50%、35.00%（P0.05）.Conclusions NACT on LACC can improve near–term curative effect and diminish rate of lymphatic metastasis and bleeding and decrease operation time and size of tumor.