不同新辅助化学治疗方法用于宫颈癌的疗效及生存期比较

Comparative Effect of Different Neoadjuvant Chemotherapy on Efficacy and Survival Time of Patients with Cervical Cancer

目的探讨不同新辅助化学治疗(简称化疗)方法对宫颈癌患者疗效及生存期的影响。方法回顾性分析医院2012年11月至2014年10月收治的宫颈癌患者142例,根据治疗方法的不同分成A,B,C,D 4组。A组30例,给予根治性手术治疗;B组37例,给予新辅助静脉化疗+根治性手术;C组37例,给予动脉、静脉化疗+根治性手术;D组38例,给予新辅助静脉化疗+腔内放疗+根治性手术。结果 B,C,D 3组总有效率分别为48.65%,75.68%,76.32%,差异有统计学意义(P<0.05);C,D两组有效率差异无统计学意义(P>0.05);术后共有87例患者接受术后辅助治疗,其中A组接受术后辅助治疗率明显高于B,C,D 3组患者(P<0.05);B,C,D3组患者接受术后辅助治疗率比较,差异无统计学意义(P>0.05);随访3年,A,B,C,D 4组患者3年无瘤生存期分别为76.67%,72.97%,79.80%,81.60%,差异无统计学意义(P>0.05);4组患者3年生存率分别为83.33%,83.78%,86.49%,89.47%,差异无统计学意义(P>0.05)。结论新辅助化疗可以有效提高患者的近期临床疗效,其中新辅助动静脉联合化疗、新辅助静脉化疗联合腔内放疗的近期临床效果显著,但4种不同方法治疗后3年无瘤生存期及3年生存期均无显著差异,不能明显改善患者的生存期。

Objective To investigate the effect of different neoadjuvant chemotherapy on the efficacy and survival time of patients with cervical cancer. Methods Totally 142 patients with cervical cancer admitted to our hospital from November 2011 to October 2014 were analyzed retrospectively and divided into group A, B, C and D according to the different treatment methods. 30 patients in group A were treated with radical surgery, 37 patients in group B were treated with neoadjuvant intravenous chemotherapy combined with radical surgery, 37 patients in group C were treated with arterial and intravenous chemotherapy combined with radical surgery, 38 patients in group D treated with neoadjuvant intravenous chemotherapy and intracavitary radiotherapy combined with radical surgery. Results The total effective rates of group B, C and D were 48. 65%, 75. 68% and 76. 32%, respectively, the difference was statistically significant （ P 〈 0. 05 ） , there was no significant difference between group C and group D （ P 〉 0. 05 ） . A total of 87 patients received postoperative adjuvant therapy, the acceptance rate of postoperative adjuvant therapy in group A was significantly higher than those in group B, C, and D （ P 〈 0. 05 ） , but there was no significant difference among the group B, C and D （ P 〉 0. 05 ） . After 3 years of follow-up, the three year disease-free survival rates of group A, B, C, and D were 76. 67%, 72. 97%, 79. 80%, 81. 60%, respectively, and the difference was not statistically significant （ P 〉 0. 05 ） . The three year survival rates of group A, B, C, and D were 83. 33%, 83. 78%, 86. 49% and 89. 47%, respectively, and the difference was not statistically significant （ P 〉 0. 05 ） . Conclusion Neoadjuvant chemotherapy can effectively improve the short-term clinical efficacy of patients, in which the recent clinical effects of neoadjuvant arterial and intravenous combined with chemotherapy , neoadjuvant intravenous chemotherapy combined with intracavitary radiotherapy are more significant. However, there was no significant difference in the three year disease-free survival and three year survival among the four treatments, and the survival time of the patients was not significantly improved.