不同用药方式的新辅助化疗对中晚期宫颈癌的疗效比较

Comparison of the Effects of Neoadjuvant Chemotherapy with Intravenous Chemotherapy and Arterial Embolization Chemotherapy on Advanced Cervical Cancer

目的:比较静脉化疗和动脉栓塞化疗两种途径新辅助化疗在Ⅱb～Illb期宫颈癌中的近期疗效。方法:选择我院妇产科60例宫颈癌患者,简单随机分组分为静脉化疗(IVCT)组30例和动脉栓塞化疗(TACE)组30例,化疗方案采用顺铂+5-氟尿嘧啶联合化疗,比较两种途径新辅助化疗的化疗有效率、化疗后手术率、手术时间、术中出血量、并发症及各种术后病理高危因素发生率。结果:与IVCT组比较,TACE组患者的化疗有效率明显升高,二者差异有统计学意义(36.7%和53.3%,χ2=14.217,P=0.042),两组患者手术率差异有统计学意义(73.3%和93.3%,χ2=12.905,P=0.047);与IVCT组比较,TACE组患者的骨髓抑制,胃肠道反应及白细胞减低的发生率明显减低,二者差异有统计学意义(χ2=16.718,36.904,18.412,P=0.038,0.0079,0.031); TACE组患者,深肌层受累、脉管癌栓及淋巴结转移的出现率低于IVCT组患者,差异有统计学意义(χ2=17.370,21.090,31.813,P=0.036,0.024,0.0081)。结论:Ⅱb～Illb期宫颈癌中动脉栓塞化疗近期疗效优于静脉化疗,还能够降低术后病理高危因素。

Objective: To observe the recental effect between the Intravenouschemotherapy(IVCT)and the transarterial chemoembolization(TACE)on cervical cancer.Methods:Sixty patients with cervical cancer in our department of obstetrics and gynecology were randomly divided into 30 patients with intravenous chemotherapy (IVCT) and 30 patients with arterial chemoembolization (TACE). Effective rate ,surgical rate ,complicaions and thevarious pathlogical risk factors incidence were analyzed and recompared . Results: Compared with IVCT group, the effective rate and surgical rate of TACE group was increased remarkably ,which was difference significantly(36.7%和53.3%,χ^ 2=14.217,P=0.042;73.3%和93.3%,χ^2=12.905,P=0.047);Compared with IVCT group, The incidence rate of myelosuppression, gastrointestinal reaction and White blood cells reduce in TACE group were lower than those of IVCT group,which were difference significantly(χ^2=16.718,36.904,18.412,P=0.038,0.0079,0.031);The incidence rate of parsmetrial involvement and deep muscleinfiltration,lymphnodemetastasis and vascularcercinomaboltransferring in TACE group were lower than those of IVCT group,which were difference significantly (χ^2=17.370,21.090,31.813,P=0.036,0.024,0.0081). Conclusion: TACE is better than that of IVCT in neoadjuvant chemotherapy on cervical cancer,especially in reducing the thevarious pathlogical risk factors incidence.