摘要
目的评价早期巨块型宫颈癌患者术前行新辅助化学疗法的近期疗效。方法回顾分析2005年10月2010年6月收治的Ⅰb~Ⅱa期巨块型宫颈癌患者90例患者的临床资料。根据术前是否行化学疗法将患者分为两组：新辅助化学疗法（neoadjuvant chemotherapy,NACT）组50例,术前予静脉化学疗法或子宫动脉灌注化学疗法治疗1~3个疗程;直接手术组40例,直接行根治性手术。比较新辅助化学疗法前后病灶大小变化,化学疗法不良反应,手术情况及术后病理情况。结果 NACT组总有效率86%（43/50）,鳞癌疗效优于腺癌,动脉与静脉化学疗法近期有效率比较,两组差异无统计学意义（P〉0.05）。NACT不良反应小。NACT组术中出血少于直接手术组,两者差异有统计学意义（P〈0.05）。两组深肌层浸润、淋巴结转移、脉管浸润差异均无统计学意义（P〉0.05）,NACT组宫旁浸润率低于直接手术组。结论术前NACT对早期巨块型宫颈癌患者近期疗效显著。
Objective To evaluate the short-term curative effect of preoperative neoadjuvant chemotherapy on the early-stage bulky cervical carcinoma.Methods We retrospectively analyzed the clinical data of 70 patients with bulky ⅠB-ⅡA cervical carcinoma treated in our hospital between October 2005 and June 2010.Based on whether the patients received chemotherapy,they were divided into two groups： neoadjuvant chemotherapy group（NACT group） and direct surgery group.In the former group,there were 50 patients who underwent surgery after 1 to 3 cycles of preoperative chemotherapy by uterus artery infusion or intravenous chemoembolization.For the 40 patients in the latter group,direct radical surgery was performed.The size of the tumor before and after chemotherapy,the operation conditions and the postoperative pathological conditions of patients between the two groups were compared and the adverse reactions of neoadjuvant chemotherapy were analyzed as well.Results The total effective rate of NACT group was 86%（43/50）.The response to chemotherapy in squamous cell caner was significantly higher than adenocarcinoma.There was no statistical difference between arterial and venous chemotherapy in terms of immediate effect（P0.05）.The incidence of adverse reactions of neoadjuvant chemotherapy was low.There was significant difference between the NACT group and the direct surgery group in intraoperative bleeding（P0.05）.There were no significant differences between the above two groups in deep muscularis infiltration rate,lymph node metastasis rate and vascular invasion rate.However,the parametrial infiltration rate for the NACT group was lower than that for the direct surgery group.Conclusion Preoperative neoadjuvant chemotherapy on patients with early-stage bulky cervical carcinoma has a remarkable immediate curative effect.
出处
《华西医学》
CAS
2011年第4期517-520,共4页
West China Medical Journal
关键词
宫颈肿瘤
新辅助化疗
近期疗效
Cervical carcinoma
Neoadjuvant chemotherapy
Immediate curative effect
