两种新辅助化疗方案在宫颈癌治疗中的临床应用

Clinical Application of Two Neoadjuvant Chemotherapy Regimens in the Treatment of Cervical Cancer

目的探讨新辅助化疗方案在Ⅰb2-Ⅱb 期宫颈癌治疗中的有效性及安全性.方法：回顾性分析2010 年1 月-2013 年12 月笔者所在医院收治的66 例术前行新辅助化疗的宫颈癌患者,按化疗方案分为两组,其中采用顺铂＋5- 氟尿嘧啶为PF 组34 例,顺铂＋ 异环磷酰胺＋ 博莱霉素为PIB 组32 例,所有患者于化疗结束后14 d 行宫颈癌根治术.结果：PF 组化疗后肿瘤体积缩小优于PIB 组,差异有统计学意义（P〈0.05）;PF 组血清鳞状细胞癌抗原（SCC） 下降明显高于PIB 组（P〈0.05）;PF 组化疗后不良反应发生率低于PIB 组（P〈0.05）;两组患者手术时间、术中出血、阴道切缘阳性、淋巴结转移情况比较,差异均无统计学意义（P〉0.05）.结论：宫颈癌新辅助化疗能够有效控制宫颈病灶,改善手术质量,提高治疗有效率.顺铂＋5- 氟尿嘧啶（PF） 方案肿瘤体积缩小及SCC 下降均较PIB 方案更理想,不良反应少,是较理想的宫颈癌新辅助化疗方案.

Objective:To explore the efficacy and safety of neoadjuvant chemotherapy in the treatment ofⅠb2~Ⅱb stage cervical cancer.Method:66 cervical cancer patients with neoadjuvant chemotherapy treatment for cervical cancer before operation in our hospital from January 2010 to December 2013 were analyzed retrospectively,according to the chemotherapy plan,they were divided into two groups,34 cases of PF group(cisplatin+5-fluorouracil),32 cases of PIB group(cisplatin+ifosfamide+bleomycin).All patients received the radical hysterectomy of cervical cancer after 14 days.Result:The tumor volume of PF group after chemotherapy was better than that of PIB group,the difference was statistically significant(P<0.05);the serum squamous cell carcinoma antigen(SCC) in PF group was significantly higher than that in group PIB(P<0.05);the incidence of adverse reactions in group PF was lower than that in group PIB(P<0.05);two groups of patients with operation time,intraoperative bleeding,vaginal resection margin positive,lymph node metastasis were compared,there were no statistically significant differences(P>0.05).Conclusion:Cervical cancer neoadjuvant chemotherapy can effectively control cervical lesions, improve the quality of surgery, improve the treatment efficiency.Cisplatin+5-PF solution tumor volume reduction and SCC decreased compared with the PIB program more ideal, less adverse reaction,it is the ideal cervical cancer neoadjuvant chemotherapy.