术前同期放化疗治疗局部晚期宫颈癌的临床观察

Analysis of preoperative concurrent chemoradiotherapy in the treatment of locally advanced cervical cancer

目的:观察紫杉醇+顺铂(TP方案)新辅助化疗联合腔内后装放疗同期治疗局部晚期宫颈癌的临床疗效。方法:作者回顾性分析了48例局部晚期宫颈癌患者的临床资料,分别于术前行新辅助化疗联合腔内后装放疗(CCR组)、新辅助化疗(NACT组),通过对这些患者在治疗前后局部病灶大小的变化、毒副反应、能否实施手术及术中情况、术后病理结果等方面的对比分析,明确术前同步放化疗在宫颈癌临床治疗中的效果及其安全性。结果:CCR组局部晚期宫颈癌的治疗有效率为92.3%,明显高于NACT组68.2%的有效率(P<0.05),CCR可明显改善宫旁浸润情况,且不会增加总的毒副反应和术后并发症的发生率。结论:新辅助化疗联合腔内后装放疗在治疗局部晚期宫颈癌中是安全有效的。

Objective：To evaluate the clinical efficacy and side effects of concurrent chemoradiotherapy on locally advanced cervical cancer by compared with neoadjuvant chemotherapy （ paclitaxel combined with DDP ） . Methods： All patients with locally advanced cervical cancer were separated into two groups： concurrent chemoradiotherapy group （ CCR group ） and neoadjuvant chemotherapy group （ NACT group ） .The effect and safety were evaluated by comparing the change of the lesion size , toxic side effects , and the condition during operation , operative complications , and pathology .Results：Compared with NACT , CCR has high effective rate （ 92.3% vs 68.2%）, and improved more in utero-tissue infiltration.But, the incidence of side effects in two groups was almost equally .There were no differences in these two groups in cervical infiltration , vaginal cutting margin infiltration, lymphatic metastasis and the incidence of postoperative complications . Conclusion： Concurrent chemoradiotherapy is a safe and effective therapeutic method for treating cervical cancer in locally advanced stage .