摘要
目的:比较ⅠB及ⅡA期宫颈癌术前介入化疗或放疗联合根治手术的疗效,探讨该期宫颈癌患者适宜的治疗方法。方法:选择温州医学院附属第二医院妇产科1998年5月～2003年5月收治的ⅠB和ⅡA期宫颈癌患者138例,所有患者肿瘤均>2cm。按FIGO分期,ⅠB1期24例,ⅠB2期48,ⅡA期66例;按肿瘤大小分为非巨块型(肿瘤直径2～4cm)53例,巨块型(肿瘤直径≥4cm)85例;术前介入化疗74例(化疗组),术前腔内放疗64例(放疗组)。对两组的近期疗效、术后病理组织学变化及中远期疗效进行比较。结果:非巨块型病例化疗组有效率为89.3%,稍高于放疗组88.0%,两组间差异无统计学意义(P>0.05)。巨块型病例化疗组有效率为84.8%,高于放疗组71.8%(P<0.05)。术后病理组织学比较,化疗组淋巴结转移率21.6%,深肌层浸润率21.6%,均低于放疗组的32.8%和34.4%(均P<0.05)。两组宫旁、阴道切缘浸润率及脉管癌栓比较差异无统计学意义(P>0.05)。非巨块型病例化疗组2年复发率为8.8%,5年生存率为83.2%,分别与放疗组10.1%及79.5%比较差异均无统计学意义(P>0.05);巨块型病例化疗组2年复发率为22.5%,5年生存率为81.4%,分别与放疗组31.9%及68.6%比较,均有统计学意义(P<0.05)。结论:巨块型ⅠB和ⅡA期宫颈癌术前应用介入化疗较术前放疗为佳;非巨块型病例术前介入化疗与术前放疗疗效相似。
Objective： To evaluate the better way in the preoperative treatment by comparing preoperative intraarterial chemotherapy and intraeavity braehytherapy radiotherapy in stage I B and ⅡA cervical cancer. Methods： Total 138 patients with stage ⅠB and ⅡA cervical cancer were included and 74 eases were treated with intraarterial chemotherapy （CT） and 64 patients underwent intraeavity braehytherapy radiotherapy （RT） respectively, followed radical hysterectomy to observe recent and forward eurtive effect as well as histopathological ob- servation after operation. Results： ①In CT group the effective rate was 89. 3% in non -bulk cervical cancer （2-4 cm）, and eflleeney in bulk tumor （≥4 em） was 84. 8%, slight higher than RT group which were 88. 0% and 71.8% respectively, but no statistical sigaaitleanee was found in non - bulk cervical cancer between two groups. ②In CT group, lymph mode metastaser （ LNM ） and myometrial infiltration were 21.6%, 21.6%, lower than those in RT group 32. 8%, 34. 4% （ P 〈 0. 05 ） ; no other significant numbers were found in surgical specimens between two groups. ③Among bulk turnout patients, in CT group the 2 - year recurrent rate and 5 - year survival rate were 22.5% and 81.4%, wheras those numbers were 31.9% and 68. 6% in RT group, the statistieal significant difference were found between two groups （ P 〈 0. 05 ）, but similar results were not found in non - bulk tumors. Conclusion： It is better to take preoperative intraarterial chemotherapy for bulk cervical carcinoma with stage ⅠB and ⅡA.
出处
《中国妇幼保健》
CAS
北大核心
2008年第16期2308-2310,共3页
Maternal and Child Health Care of China
关键词
宫颈癌
术前介入化疗
术前介入放疗
疗效
Cervical cancer
Preoperative intraarterial chemotherapy
Preoperative intracavity brachytherapy radiotherapy
Efficacy
