新辅助化疗后手术对中晚期宫颈癌的临床效果

Clinical effect of surgery after neoadjuvant chemotherapy on middle and advanced cervical cancer

目的探讨新辅助化疗(NACT)后手术对中晚期宫颈癌患者的临床价值。方法回顾性分析2016年6月~2019年6月在我院行宫颈癌根治术的76例中晚期宫颈癌患者的临床资料,根据术前是否接受NACT,将其分为研究组(n=38)和对照组(n=38)。通过分析研究组化疗后总有效率及两组患者手术时间、术中出血量、淋巴结转移率及脉管浸润率来评估NACT后手术对中晚期宫颈癌患者的临床价值。结果研究组患者接受NACT后均成功施行了手术,总有效率为65.79%(25/38),其中CR为0.00%(0/38),PR为65.79%(25/38),SD为34.21%(13/38),PD为0.00%(0/38)。两组患者的手术时间和术中出血量比较,差异无统计学意义(P>0.05);研究组患者的淋巴结转移率及脉管浸润率低于对照组,差异有统计学意义(P<0.05)。结论NACT后手术对中晚期宫颈癌的疗效较好,能缩小病灶大小,且不增加手术难度,为中晚期宫颈癌患者的治疗提供了又一选择。

Objective To evaluate the clinical value after neoadjuvant chemotherapy(NACT)in patients with middle and advanced cervical cancer.Methods The clinical data of 76 patients with middle and advanced cervical cancer who underwent radical surgery of cervical cancer in our hospital from June 2016 to June 2019 were retrospectively analyzed,and divided them into research group(n=38)and control group(n=38)according to whether they received NACT before surgery.By analyzing the total effective rate after chemotherapy in the research group and the surgery time,intraoperative blood loss,lymph node metastasis rate and vascular invasion rate of the two groups of patients,the clinical value of surgery after NACT for patients with middle and advanced cervical cancer was evaluated.Results All patients in the research group successfully performed surgery after receiving NACT,with a total effective rate of 65.79%(25/38),of which CR was 0.00%(0/38),PR was 65.79%(25/38),and SD was 34.21%(13/38),PD was 0.00%(0/38).There were no significant differences in the surgery time and intraoperative blood loss between the two groups of patients(P>0.05).The lymph node metastasis and vascular infiltration rate of the research group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion NACT before radical surgery of cervical cancer has good effect on middle and advanced cervical cancer,it can reduce the size of cancer,and does not increase the difficulty of surgery,which provides another option for the treatment of patients with middle and advanced cervical cancer.