手术联合放、化疗与单纯手术治疗Ⅰa~Ⅱa期宫颈鳞癌患者的疗效比较

Comparison of Clinical Effects of Radical Surgery Combined with Chemoradiotherapy and Radical Surgery Alone in the Treatment for Cervical Squamous Cell Carcinoma StageⅠa~Ⅱa

[目的]观察宫颈癌根治术联合放、化疗治疗Ⅰa~Ⅱa期宫颈鳞癌患者的临床疗效,并与单纯根治手术疗效进行比较。[方法]采用回顾性分析方法,将2007年1月至2012年7月期间收治的经根治手术治疗并具有复发、转移高危因素的94例Ⅰa~Ⅱa期宫颈鳞癌患者的临床相关资料进行整理、分析,其中63例患者宫颈癌根治术后3~5个月内行盆腔外放疗加TP方案全身化疗2~4周期;另外31例患者仅行单纯宫颈癌根治手术治疗,对两组患者的临床疗效进行比较分析。[结果]随访时间为12~79个月,中位随访37个月,随访期内,手术联合放、化疗组与单纯手术组的盆腔或阴道残端局部复发率分别为3.17%和61.29%,远处脏器或组织转移率分别为17.46%和51.61%,差异均有显著统计学意义（P〈0.05）。[结论]对于Ⅰa~Ⅱa期宫颈鳞癌根治性手术后具有复发、转移高危因素的患者,术后联合放、化疗能明显降低其局部复发率及远处转移率,具有较高的临床应用价值。

[Purpose] To compare clinical effects of radical surgery combined with chemoradiotherapy and radical surgery alone in the treatment for cervical squamous cell carcinoma stageⅠa~Ⅱa.[Methods] Ninety-four cases with cervical squamous cell carcinoma stageⅠa~Ⅱa were enrolled and analyzed retrospectively.Of 94 cases,63 cases treated with radical surgery combined with chemoradiotherapy（pelvic radiotherapy plus TP regimen chemotherapy 2~4 cycles）,while 31cases treated with radical surgery alone.[Results] The time of follow-up was 12~79 months,with a median follow-up of 37 months.The pelvic or vaginal stump recurrence rates of radical surgery combined with chemoradiotherapy group and surgery alone group were 3.17% and 61.29%,distant or local metastasis rates were 17.46% and 51.61% respectively,with significant difference（P0.05）.[Conclusion] Radical surgery combined with chemoradiotherapy in the treatment for cervical squamous cell carcinoma stageⅠa~Ⅱa is able to improve local recurrence and distant metastasis rate,with a high clinical value.