双侧子宫动脉灌注化疗在局部晚期宫颈癌治疗中的价值及安全性分析

Outcomes and safety analysis of bilateral uterine artery infusion chemoembolization in locally advanced cervical cancer

目的:分析局部晚期宫颈癌的临床治疗中采取双侧子宫动脉灌注化疗的价值,评价安全性。方法:回顾性分析2017年5月~2020年5月弋矶山医院收治的56例接受新辅助化疗的局部晚期宫颈癌患者的病历资料。采用双侧子宫动脉灌注化疗的28例患者作为观察组;采用静脉全身化疗的28例患者作为对照组。通过临床疗效、肿瘤标志物水平、副反应情况及手术病理情况进行两组间对比分析。结果:观察组患者治疗的总有效率(78.57%)高于对照组(50.00%)(P<0.05),观察组治疗后肿瘤标志物水平下降幅度均大于对照组(P<0.05);两组患者的手术病理结果(包括盆腔淋巴结阳性率、切缘阳性率、宫旁阳性率、脉管浸润率)差异均无统计学意义(P>0.05);观察组副反应发生率略低于对照组,但差异无统计学意义(P>0.05)。结论:局部晚期宫颈癌患者实施双侧子宫动脉灌注化疗的新辅助化疗方式效果显著,能有效缩小肿瘤大小,降低肿瘤标志物水平。

Objective:To analyze the clinical effects and safety of bilateral uterine artery infusion chemoembolization in patients with locally advanced cervical cancer.Methods:The medical records were retrospectively analyzed in 56 cases of locally advanced cervical cancer undergone neoadjuvant chemotherapy in our hospital between May 2017 and May 2020.The patients received bilateral uterine arterial infusion chemotherapy were included in observational group(n=28),and those undergone systemic intravenous chemotherapy were included in control group(n=28).The efficacy and safety were analyzed concerning the clinical outcomes,changes of tumor markers,adverse response and findings of surgical pathology between the two groups.Results:Total effective rate of the observational group was higher than that of control group(78.57%vs.50.00%,P<0.05),and significantly reduced level of tumor markers after treatment was seen in patients in the observational group(P<0.05).The findings of surgical pathology remained insignificant in the positive rate of pelvic lymph nodes,incisal margin and para-uterine as well as the rate of vascular infiltration between the two group(P>0.05).Patients in the observational group had lower adverse reactions than those in the control group,yet there was no significant difference(P>0.05).Conclusion:The neoadjuvant chemotherapy by bilateral uterine artery infusion chemoembolization can greatly reduce the tumor size and down-regulate the levels of tumor markers,which suggests that this regimen is definitely effective for patients with locally advanced cervical cancer.