紫杉醇联合顺铂新辅助化疗治疗局部晚期子宫颈癌的疗效分析

Efficacy of Neoadjuvant Chemotherapy with Paclitaxel plus Cisplatin for Locally Advanced Cervical Cancer

目的 探讨紫杉醇联合顺铂新辅助化疗治疗局部晚期子宫颈癌的疗效。方法 回顾分析130例接受子宫广泛切除术以及盆腔淋巴结清扫术的局部晚期子宫颈癌患者的临床资料,根据治疗方案将这些患者分为新辅助化疗组（74例）与直接手术组（56例）,前者在术前行1~3个疗程的紫杉醇联合顺铂新辅助化疗。结果 新辅助化疗组血清糖类抗原125（CA125）、鳞状细胞癌抗原（SCCA）、肿瘤直径在化疗前后差异有统计学意义（P〈0.01）。新辅助化疗组完全缓解（CR）12例、部分缓解（PR）43例、疾病稳定（SD）11例、疾病进展（PD）8例,总缓解率74.3%,疾病控制率89.2%。新辅助化疗组手术时间、术中出血量、术后病理检查淋巴结转移率显著低于直接手术组,差异有统计学意义（P〈0.05）,但2组患者术后病理检查深肌层受累率、淋巴脉管间隙浸润率、切缘阳性率等情况差异无统计学意义（P〉0.05）。结论紫杉醇联合顺铂新辅助化疗治疗局部晚期子宫颈癌的近期疗效良好,具有缩小肿瘤体积、降低手术难度、减少手术损伤、降低淋巴结转移率等优点。

Objective To explore the efficacy of neoadjuvant chemotherapy with paclitaxel plus cisplatin for locally advanced cervical cancer. Methods Clinical data of 130 cases of locally advanced cervical cancer who received extensive hysterec- tomy and pelvic lymph node dissection were analyzed retrospectively, and these patients were divided into neoadjuvant chemotherapy group（74 cases）and direct surgery group（56 cases）according to their therapeutic regimens, the former before operation re- ceived 1 to 3 cycles of paclitaxel plus cisplatin neoadjuvant chemotherapy. Results Serum carbohydrate antigen 125 （ CA125）, squamous cell carcinoma antigen （SCCA）, tumor diameter in neoadjuvant chemotherapy group before and after chemotherapy had statistical difference（P 〈 0.01 ）. There were 12 cases of complete remission （CR） ,43 cases of partial remission （ PR）, 11 cases of stable disease （SD）and 8 cases of progressive disease （PD）in neoadjuvant chemotherapy group, and the total remission rate and disease control rate were 74.3% and 89.2%, respectively. Operation time, intraoperative blood loss, lymph node metastasis rate in neoadjuvant chemotherapy group were obviously lower than those of direct surgery group, there had statistical difference （P 〈 0.05 ）, while there had no obvious differences in incidence of deep muscular layer involvement, lymphatic vessel invasion and positive margin between the 2 groups （P 〉 0.05）. Conclusion Neoadjuvant chemotherapy with paclitaxel plus cisplatin shows good short-term efficacy in the treatment of locally advanced cervical cancer, such as reducing tumor volume, operation difficulty, surgical injury and lymph node metastasis rate etc.