术前序贯放化疗治疗局部巨块型宫颈癌的近期疗效

Short-term effect of preoperative sequential chemo-radiotherapy in the treatment of local bulky cervical cancer

目的 研究术前序贯放化疗治疗局部巨块型宫颈癌的近期临床疗效.方法 67例Ⅰb2～Ⅱa期局部巨块型（癌灶直径＞4 cm）宫颈癌患者随机分成研究组（35例）和对照组（32例）.两组患者术前均给予盆腔外照射放疗,研究组分别于放疗前、后给予TP（紫杉醇＋顺铂）方案化疗一程,对照组放疗期间给予顺铂周化疗.比较两组放化疗后近期有效率、手术病理完全缓解率、毒副反应等.结果 研究组放化疗后近期有效率94.28％,对照组96.87％,两组比较差异无统计学意义（P＞0.05）.两组均有较明显的骨髓抑制和消化道反应,但患者经治疗后均可耐受.手术病理完全缓解率：研究组14.29％,对照组15.62％,两组比较差异无统计学意义（P＞0.05）.结论 巨块型宫颈癌术前序贯放化疗和同步放化疗两者疗效相当.术前序贯放化疗操作更灵活,便于推广,使更多患者受益.

Objective To study the short-term effect of preoperative sequential chemoradiotherapy in the treatment of local bulky cervical cancer.Methods 67 cases of local bulky cervical cancer at stage Ⅰ b2-Ⅱ a （foci of cancer ＞ 4 cm） were randomly divided into study group （35 cases） and control group （32 cases）.All patients received radiotherapy before operation.Study group was given TP model chemotherapy （paclitaxel ＋ cisplatin） before and after radiotherapy,while control group was given eisplatin during radiotherapy.The short-term efficacy,pathologically complete regressiou （PCR） and toxicity of two groups were compared.Results The short-term efficacy of study group was 94.28％,and that of control group was 96.87％,without statistically significant difference betweeu two groups （P ＞ 0.05）.There were obvious myelosuppressiou and reaction of digestive tract in two groups,which patients could suffered after treatment.Pathologically complete regression of study group was 14.29％,and that of control group was 15.62％,without statistically significant difference between two groups （P ＞ 0.05）.Conclusions Preoperative sequential chemo-radiotherapy has equivalent efficacy to concurrent chemo-radiotherapy in the treatment of bulky cervical cancer.Preoperative sequential chemo-radiotherapy is more flexible in the treatment and will benefit more patients,worthy of promotion.