Effect of neoadjuvant chemotherapy in combined with laparoscopy on the molecular markers and immune function in patients with locally advanced cervical cancer

Objective: To explore the efficacy of paclitaxel plus cisplatin (TP) neoadjuvant chemotherapy in combined with laparoscopy in the treatment of locally advanced cervical cancer and their effect on the molecular markers and immune function. Methods: A total of 92 patients with locally advanced cervical cancer were included in the study and divided into the control group (n=46) and the treatment group (n=46) according to the admission number. The patients in the control group were given 5- fluorouracil plus cisplatin (PF);neoadjuvant chemotherapy in combined with laparoscopic radical hysterectomy. The patients in the treatment group were given TP neoadjuvant chemotherapy in combined with laparoscopic radical hysterectomy. The clinical efficacy in the two groups was compared. The levels of molecular markers and the change of immune function in the two groups were detected and compared. The adverse reactions in the two groups were observed and compared. Results: After chemotherapy;in the treatment group;CR was 39.13%;PR was 41.30%;NC was 13.04%;PD was 6.52%;and the total effective rate was 80.43%;while those in the control group were 21.74%;26.09%;30.43%;21.74%;and 47.83%;respectively. The total effective rate in the treatment group was significantly higher than that in the control group. The comparison of the occurrence rate of adverse reactions between the two groups was not statistically significant. CEA;SCC-Ag;CYFRA21-1;and CA125 levels 2 weeks after operation in the two groups were significantly reduced when compared with before treatment;and those in the treatment group were significantly lower than those in the control group. MMP-2;TIMP-2;VEGF-C;and VEGF-D levels 2 weeks after operation in the two groups were significantly reduced when compared with before treatment;and those in the treatment group were significantly lower than those in the control group. CD3+;CD4+;and CD8+ 2 weeks after operation in the two groups were significantly reduced when compared with before treatment;while CD4+/CD8+was significantly elevated;but the comparison between the two groups was not statistically significant. Conclusions: Given TP neoadjuvant chemotherapy in combined with laparoscopy in patients with locally advanced cervical cancer can obviously enhance the patient's clinical efficacy;reduce the molecular markers in the body;effectively improve the patient's immune functionwith less adverse reactions and accurate efficacy;therefore;they are safe and reliable.

Efficacy of neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer and safety evaluation

Objective: To explore the efficacy of different neoadjuvant chemotherapy (NACT ) i n t h e treatment of locally advanced cervical cancer (LACC) and safety evaluation. Methods: A total of 68 patients with LACC who were admitted in our hospital from April;2015 to August;2016 were included in the study and divided into the observation group (n=34) and the control group (n=34) according to different chemotherapy regimens. The patients in the observation group were given docetaxel and oxaliplatin (DTX+OXA);while the patients in the control group were given TAX and DDP. 21 d-treatment was regarded as one course;for 2 courses. After treatment;the patients in the two groups were given laparoscopic extensive hysterectomy;pelvic lymph node dissection;and abdominal aortic lymph node sampling. The short-term efficacy and adverse reactions in the two groups were observed. Pathological evaluation of postoperative specimens in the two groups was performed. The peripheral blood T lymphocyte subsets and NK cell in the two groups were detected and compared. Results: ORR and DCR in the observation group were 47.09% and 91.18%;respectively;while those in the control group were 44.12% and 85.29%;respectively;and the comparison between the two groups was not statistically significant. When compared with before treatment;CD4+;CD8+;and NK cell after treatment in the two groups were significantly reduced;while CD4+/CD8+ was significantly increased;but the comparison between the two groups was not statistically significant. It was proved by the postoperative pathology that the comparison of PCR;PR1;and PR2 between the two groups was not statistically significant. Meanwhile;the comparison of cervical infiltration depth;surgical incision;parametrial infiltration;and pelvic lymph node metastasis between the two groups was not statistically significant. The proportion of alopecia;gastrointestinal reaction;and renal toxicity in the observation was significantly lower than that in the control group;but the proportion of peripheral neurotoxicity was significantly higher than that in the control group. Conclusions: Before laparoscopy;the short-term efficacy of DTX+OXA and TAX+DDP in the treatment of LACC is equal;but DTX+OXA has a lower toxic reaction;and higher safety;therefore;it deserves to be recommended in the clinic.