术前新辅助化疗治疗局部晚期宫颈癌的临床观察

Efficacy of preoperative neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer

目的探讨术前新辅助化疗治疗局部晚期宫颈癌的临床效果。方法选取2014年6月至2016年6月间山东省临朐县人民医院收治的90例Ⅰb2~Ⅱa2期局部晚期宫颈癌患者,采用随机数表法分为观察组和对照组,每组45例。观察组患者术前给予新辅助化疗后再行宫颈癌根治术,对照组患者直接给予宫颈癌根治术,对比两组患者临床疗效、手术时间、术中出血量、盆腔淋巴结转移、脉管栓塞及阴道切缘肿瘤浸润率。结果观察组患者治疗总有效率为84.4%,高于对照组患者的66.7%,组间比较差异有统计学意义(P<0.05)。观察组患者手术时间、术中出血量和并发症发生率分别为(2.84±0.45)h、(1023.90±450.43)ml和6.7%,对照组患者分别为(3.41±0.63)h、(1345.45±467.56)ml和15.6%,两组比较,差异均有统计学意义(均P<0.05)。观察组患者盆腔淋巴结转移率、脉管栓塞率和阴道切缘肿瘤浸润率分别为8.9%、6.7%和11.1%,均低于对照组患者的22.2%、17.8%和26.7%,差异均有统计学意义(均P<0.05)。结论新辅助化疗治疗后行全子宫切除术治疗局部晚期宫颈癌的近期疗效显著,适于临床推广使用。

Objective To probe into the efficacy of preoperative neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer. Methods Ninety patients with stage Ⅰ b2 ～ Ⅱ a2 locally advanced cervical cancer treated at Linqu County People＇s Hospital from June 2014 to June 2016 were selected. Using a random number table method,patients were divided into an observation group and a control group with 45 patients in each group. Patients in the observation group were given neoadjuvant chemotherapy before radical hysterectomy was performed and patients in the control group directly underwent radical hysterectomy. Clinical efficacy,operation time,intraoperative blood loss,pelvic lymph node metastasis,vascular embolization and infiltration of the tumors around the cutting edge of vagina were compared between the two groups. Results The overall efficacy rate was 84. 4% for the observation group which was higher than66. 7% of the control group（P〈0. 05）. The incidence of operation time,intraoperative blood loss and complication was（2. 84 ± 0. 45） h,（1023. 90 ± 450. 43） ml and 6. 7% respectively for the observation group and（3. 41 ± 0. 63） h,（1345. 45 ± 467. 56） ml and 15. 6% respectively for the control group（all P〈0. 05）. The incidence of pelvic lymph node metastasis,vascular embolization and infiltration of the tumors around the cutting edge of vagina was 8. 9%,6. 7% and 11. 1% respectively which was lower than22. 2%,17. 8% and 26. 7% of the control group respectively（all P〈0. 05）. Conclusion Preoperative neoadjuvant chemotherapy plus subsequently complete hysterectomy in the treatment of locally advanced cervical cancer has remarkable short-term curative efficacy.