新辅助化疗治疗ⅠB2～ⅡB期宫颈癌的疗效分析

Efficacy of Neoadjuvant Chemotherapy for Stage ⅠB2 ～ ⅡB Cervical Cancer

目的探讨新辅助化疗治疗ⅠB2~ⅡB期宫颈癌的疗效。方法选择经病理诊断为ⅠB2~ⅡB期的90例宫颈癌患者,根据入院时间先后顺序,分为对照组及观察组,2010年1月至2013年6月收入院的为对照组,共48例,行宫颈癌根治性手术,2014年7月至2015年12月收入院的为观察组,共42例,行新辅助化疗联合根治性手术治疗。观察两组术后的疗效,对比两组的手术时间、术中出血量、膀胱功能恢复时间及术后住院时间、病理情况(术后脉管内癌栓、阴道断端癌残留、淋巴结转移)、术后生存情况及观察组的化疗毒副作用。结果观察组不同分期患者有效率对比差异无统计学意义,P>0.05。观察组的手术时间及术中出血量明显优于对照组,P<0.05。两组的膀胱功能恢复时间及术后住院时间对比,差异无统计学意义,P>0.05。两组的脉管内癌栓率及阴道断端癌残留率对比差异无统计学意义,P>0.05;观察组的淋巴结转移率明显低于对照组,P<0.05。两组均随访14个月,观察组术后复发率为4.8%;对照组术后复发率为16.7%,观察组明显低于对照组。观察组42例患者中38例不良反应轻微,4例无反应,对症处理后可以完成化疗疗程。结论新辅助化疗治疗ⅠB2~ⅡB期宫颈癌的安全有效,可以降低术后淋巴结转移率及复发率。

Objective To investigate the efficacy of neoadjuvant chemotherapy for stage ⅠB2 ~ ⅡB cervical cancer.Methods 90 cases of stage ⅠB2 ~ ⅡB cervical cancer were divided into the control group and the observation group,the control group were given cervical cancer radical surgery,the observation group were given neoadjuvant chemotherapy combined radical surgery. The efficacy,operation time,intraoperatve blood loss,bladder function recovery time and post operation hospitalization duration,pathologic condition（ postoperative vascular tumor emboli,vaginal end residual cancer,lymph node metastasis）,survival situation and chemotherapy side effects of the 2 groups were compared. Results The efficacy at different stage had no significant difference,P〈0. 05; The operation time and intraoperative blood loss of the observation group were better than the control group,P〈0. 05; The bladder function recovery time and postoperative hospitalization duration of the 2 groups had no significant difference,P〈0. 05. The cancer within the vascular tumor emboli rates and vaginal cuff from this residual rates of the 2 groups had no significant difference,P〈0. 05. The lymph nodes metastasis rate of the control group was lower than the observation group,P〈0. 05. The postoperative recurrent rate of the observation group was 4. 8%,the control group was 16. 7%,the observation group was higher than the control group. 38 cases had less side effects,4 cases had no side effects,all patients completed the chemotherapy treatment course after treatment. Conclusion Neoadjuvant chemotherapy treatment for stageⅠB2 ~ ⅡB cervical cancer is safe and effective,and it can decrease lymph node metastasis rate and postoperative recurrence rate.