新辅助化疗治疗局部肿块〉3cm的宫颈癌ⅡB期的临床研究

Neoadjuvant chemotherapy for stage ⅡB cervical cancer whose local mass 〉 3 cm

目的研究分析新辅助化疗治疗局部肿块〉3m的宫颈癌ⅡB期患者的临床疗效。方法将66例患者随机分为3组，其中22例接受紫杉醇联合顺铂新辅助化疗方案（TP组）后行手术治疗，22例接受伊立替康联合顺铂新辅助化疗方案（IP组）后行手术治疗；另22例患者直接进行手术（DS组）。评价3组患者术中出血量、手术时间及术后病理高危因素发生率及新辅助化疗组的疗效和不良反应发生率。结果与直接手术组相比，新辅助化疗组患者手术时间及术中出血量比较差异无统计学意义；发生深基质浸润的概率低于直接手术组，差异有统计学意义。IP组新辅助化疗方案的有效率为68．18％，与TP组相比差异无统计学意义；IP组性粒细胞减少及腹泻的发生率分别为59．09％及27．27％，与TP组相比差异有统计学意义。结论新辅助化疗治疗局部肿块〉3cm的宫颈癌可减少手术时间与术中出血量，降低手术难度及术后高危因素的发生率。

Objective To study and analyze the clinical curative effect neoadjuvant chemotherapy in the treatment of stageⅡ B cervical cancer whose local mass 〉 3 cm. Methods 66 patients were randomly divided into a TP group, an IP group, and a DS group, 22 for each group. The TP group took paclitaxel and cisplatin as neoadjuvant chemotherapy and then were surgically treated. The IP group took irinotecan and cisplatin as neoadjuvant chemotherapy and then were surgically treated. The DS group were surgically treated. The intraoperative bleeding volume, operation time, incidence of postoperative pathologic risk factors, clinical efficacy, and incidence of complications were compared between these three groups. Results There were no statistical differences in operation time and intraoperative bleeding volume between the TP group and the IP group and the DS group. The incidence of deep stromal infiltration was lower in the TP group and the IP group than in the DS group. The effective rate was 68.18% in the IP group, which was not statistically different from that in the TP group. The incidences of neutropenia and diarrhea were 59.09% and 27.27% in the IP group, which were statistically different from those in the TP group. Conclusions Neoadjuvant chemotherapy for stage Ⅱ B cervical cancer whose local mass 〉 3 cm can reduce operation time, intraoperative bleeding volume, and operative difficulty and decrease the incidence of postoperative high risk factors.