两种术前新辅助化疗给药方式对ⅠB2～ⅡA2期宫颈癌患者手术相关临床指标水平、生存时间及毒副作用的影响

Influence of two ways of drug delivery of preoperative neoadjuvant chemotherapy on the operation-related clinical index,survival time and adverse reaction of patients with cervical cancer for Ⅰ B2～Ⅱ A2 stage

目的探讨术前静脉滴注与动脉介入栓塞化疗对ⅠB2~ⅡA2期宫颈癌患者手术相关临床指标水平、生存时间及毒副作用的影响。方法选取2012年3月至2014年3月陕西中医药大学第二附属医院收治的ⅠB2-ⅡA2期宫颈癌患者80例,按给药方式分为静脉组(40例)和动脉组(40例),分别在术前给予静脉滴注和动脉介入栓塞化疗。比较两组患者手术相关临床指标水平,客观缓解率,疾病控制率,随访生存率、复发转移率及毒副作用发生率。结果动脉组患者第一次化疗后可手术率高于静脉组,术前住院时间和化疗至手术时间短于静脉组,总治疗费用高于静脉组,患者Ⅲ-Ⅳ度消化道反应和骨髓抑制发生率低于静脉组,以上各项两组比较差异均有统计学意义(P<0.05);两组患者新辅助化疗客观缓解率、疾病控制率、生存率和复发转移率比较差异均无统计学意义(P>0.05)。结论ⅠB2~ⅡA2期宫颈癌患者行术前静脉滴注与动脉介入栓塞化疗后临床疗效较为接近;动脉介入栓塞方式给药可有效缩短化疗时间,早期完成手术治疗,避免严重毒副作用发生,但可能增加患者经济负担。

Objective To investigate the influence of different preoperative neoadjuvant chemotherapy（ intravenous infusion and arterial embolization） on the operation-related clinical index,survival time and adverse reaction of patients with cervical cancer forⅠ B2-Ⅱ A2 stage.Methods 80 patients with cervical cancer for ⅠB2-ⅡA2 stage in Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from March 2012 to March 2014 were chosen and divided into intravenous group（ 40 cases）and arterial group（ 40 cases） by different drug delivery methods.Two groups were given intravenous infusion and arterial embolization chemotherapy respectively before surgery.The levels of surgically related clinical indicators,objective remission rate（ ORR）,disease control rate（ DCR）,follow-up survival rate,recurrence and metastasis rate,and the incidence of toxic and side effects were compared between the two groups.Results The surgery rate of patients in the arterial group after the first chemotherapy was higher than that in the intravenous group.Preoperative hospital stay and chemotherapy to operation time were shorter than those in the intravenous group.The total cost of treatment was higher than that of the intravenous group.Patients with Ⅲ-Ⅳ gastrointestinal reactions and myelosuppression occurring rate in the arterial group were lower than the intravenous group（ P 0.05）.There was no significant difference in objective remission rate,disease control rate,survival rate and recurrence and metastasis rate between the two groups（ P 0.05）.Conclusion The clinical efficacy of preoperative intravenous infusion and arterial embolization chemotherapy in patients with stage I B2 to II A2 cervical cancer is relatively close; arterial interventional embolization can effectively shorten the chemotherapy time,complete surgical treatment early,to avoid serious side effects,but it may increase the economic burden on patients.