不同新辅助化疗对局部晚期宫颈鳞癌治疗的探讨

A probe into different neoadjuvant chemotherapy for patients with locally advanced cervical squamous cell carcinoma

目的:观察采用两种不同的化疗方案对局部晚期宫颈鳞癌患者术前辅助治疗中的临床疗效。方法:选择2005年1月至2012年10月我院初治经病理确诊的200例Ⅰb2～Ⅱb期宫颈鳞癌患者为研究对象。遵循随机化原则分为两组,每组各100例,为TP(多西紫杉醇联合顺铂)方案组和PCB(顺铂联合环磷酰胺及博莱霉素)方案组,PCB组采用双子宫动脉栓塞及髂内动脉灌注治疗。观察两组的近期疗效及宫旁浸润、脉管栓塞、淋巴结的转移、毒副反应等情况。结果:TP方案组临床近期有效率为93%,PCB方案组临床近期有效率为53%,两组方案的有效率差异有统计意义;在毒副反应方面,TP方案组要高于PCB方案组(P<0.05)。结论:两组不同的新辅助化疗方案对治疗Ⅰb2～Ⅱb期宫颈癌均有效(差异无统计学意义);但在不良反应及副作用上,PCB方案较TP方案少。

Objective： To observe clinical efficacy of two different chemotherapy in preoperative adjuvant treatment for patients with locally advanced cervical squamous cell carcinoma. Methods：From Jan 2005 to Oct 2012 in the hospital,200 cases of I b2- IIb cervical squamous cell carcinoma patients were selected who were divided into two groups by random, namely TP （docetaxel and cisplatin） treatment regimen and PCB （cisplatin in combination with cyclophosphamide and bleomycin, adopting the double uterus artery embolization and intemal iliae artery infusion therapy） treatment regimen, 100 eases for each group. The recent efficacy ,parametrial invasion,vascular thrombosis,lymph node metastasis and toxic side effects of two regimens were observed. Results：Recent clinical efficacy of TP regimen was 93%, and that of PCB regimen was 53% in which the efficiency variance was statistically significant. In terms of toxic side effects,TP regimen was more obvious than PCB regimen （P〈0.05）. Conclusion：Both of the neo-adjuvant chemotherapy are valid in I b2- II b locally advanced cervical squamous ceU carcinoma treatments in which the difference between them is not statistically significant. However, in terms of adverse reactions and side effects,PCB regimen is less than TP regimen.