紫杉醇联合洛铂治疗局部晚期子宫颈鳞状细胞癌临床分析

The clinical analysis of Paclitaxel combined with Lobaplatin chemotherapy in locally advanced squamous cell carcinoma of cervix

目的研究评价紫杉醇联合洛铂(lobaplatin,LBP)化疗方案在局部晚期(Ⅰb2、Ⅱa2)子宫颈鳞状细胞癌治疗中的临床价值。方法选取2013年1月至2017年2月福建医科大学附属泉州第一医院治疗的94例Ⅰb2、Ⅱa2期子宫颈鳞状细胞癌患者,分为新辅助化疗加手术组(新辅助化疗)和直接手术组进行研究,新辅助化疗组在进行紫杉醇加洛铂静脉化疗后施行宫颈癌根治术,直接手术组直接行手术治疗,观察新辅助化疗近期效果并比较两组的术后病理特点、术后补充化放疗率等指标。结果新辅助化疗组总有效率为84.31%(43/51),完全缓解率为23.53%(12/51),无病情进展病例。术前新辅助化疗组淋巴结阳性率为15.68%(8/51)、子宫旁浸润率为5.88%(3/51)及术后补充治疗率为56.86%(29/51)均低于直接手术组34.88%(15/43)、20.93%(9/43)、76.74%(33/43),差异有统计学意义(P<0.05)。两组术后阴道切缘阳性率比较差异无统计学意义。结论紫杉醇联合洛铂术前新辅助化疗在局部晚期子宫颈鳞状细胞癌治疗中安全有效,具有重要的临床应用价值。

Objective To evaluate the clinical value of paclitaxel combined with lobaplatin chemotherapy in locally advanced squamous cell carcinoma of cervix (Ⅰb2,Ⅱa2).Methods 94 patients with locally advanced squamous cell carcinoma of cervix (Ⅰb2 and Ⅱa2),treatedin the Quanzhou No.1 hospital from January 2013 and February 2017,were enrolled into study.All the patients were devided into group of neoadjuvant chemotherapy followed by surgery and group of surgery alone.Patients in group of neoadjuvant chemotherapy followed by surgery are treated with radical resection of uterine cancer after paclitaxel combined lobaplatin intravenous chemotherapy.While,patients in group of surgery alone were directly undergone surgery.Observe the effect ofneoadjuvant chemotherapy and compare postoperative pathology index and Postoperative chemo-radiotherapy rate index between the two groups.Results The overall effective rate in the group of neoadjuvant chemotherapy was 84.31%(43/51),the complete remission rate in the group of neoadjuvant chemotherapy was 23.5%(12/51),no cases in progression.Lymph node positive rate (15.68%,8/51) before surgery in group of neoadjuvant chemotherapy,parametrial infiltration rate (5.88%,3/51) and supplementary treatment rate (56.86%,29/51) after surgery were all lower than those in surgery alone group 34.88%(15/43),20.93%(9/43),76.74%(33/43).The difference was statistical significant (P< 0.05).The postoperative vaginal cut margin positive rate between the two groups had no significant difference.Conclusion The neoadjuvant chemotherapy of paclitaxel combined lobaplatin before suegery on locally advanced squamous cell carcinoma of cervix at was safe and effective.It had an important value in clinical application.