TP新辅助化疗方案治疗Ib-Ⅱa期局部晚期宫颈癌的临床效果观察

Clinical Efficacy of Neoadjuvant Chemotherapy with TP Scheme in Treatment of Local late Stage Ib-Ⅱa Cervical Cancer

目的:观察并探讨宫颈癌术前行TP与PF两种新辅助化疗方案的临床效果,优选新辅助化疗方案。方法:将2008年1月-2010年12月间入选的91例Ib-Ⅱa宫颈癌患者随机分为A(n=46)、B(n=45)两组,A组患者子宫切除术前予TP新辅助化疗方案,B组予PF方案,各2个周期,对比化疗结束后两组临床疗效、化疗期间药物毒性反应及术后2年内宫颈癌复发率。结果:①A、B两组总体有效率分别为89.1%、82.2%,差异不具有统计学意义(P>0.05),但前者化疗后瘤体直径明显小于B组(P<0.05);②两组药物毒性反应构成不具有统计学差异(P>0.05),但A组胃肠道反应与肝脏毒性发生率明显低于B组(P<0.05);③A、B两组组术后2年内宫颈癌复发率分别为2.2%、11.9%,复发率无统计学差异(P>0.05)。结论:宫颈癌术前TP新辅助化疗方案较之BIP方案具有比较优势,更具备临床推广价值。

Objective：The paper is to investigate and explore the clinical effect of cervical cancer underwent TP or PF two kinds of neoadjuvant chemotherapy（NACT）,and to prefer the better neoadjuvant chemotherapy scheme.Methods：91 cases from Jan.2008 to Dec.2010 were randomized divided into A（n=46） B（n=45） group,group A was given TP（DDP ＋TAX） NACT scheme before radical hysterectomy,group B was given PF（DDP＋5-Fu） scheme,and each with 2 treatment cycles,comparison on clinical effect after NACT,drug toxicity and recurrence rate within 2 years after hysterectomy were conducted between 2 groups.Results：①0verall efficiency of A,B group were 89.1%,82.2% respectively,the difference was not statistically significant（P〉0.05）,but the diameter of tumor of group A after chemotherapy was significantly less than that of group B（P〈0.05）;②Constitution of drug toxicity of 2 groups was not statistically different（P〉0.05）,but the incidence rate of gastrointestinal reaction liver toxicity of group A was significantly lower than that of group B（P〈0.05）;③Recurrence rates of A B group within 2 years after surgery were 2.2%,11.9% respectively,also with no significant difference（P〉0.05）.Conclusion：Neoadjuvant chemotherapy of TP scheme compared with BIP scheme has comparative advantage,and have more clinical value of popularization.