摘要
目的比较应用3种新辅助化疗方法治疗Ⅰb2～Ⅱb期宫颈鳞状细胞癌的近期疗效。方法回顾性分析应用新辅助化疗方法治疗的50例Ⅰb2～Ⅱb期宫颈鳞状细胞癌患者,其中全身化疗组13例,单纯动脉化疗(TAC)组19例,动脉栓塞化疗(TACE)组18例。观察化疗后的肿瘤缓解情况、肿瘤缩小率及不良反应、术中出血以及术后标本提示的预后不良因素(包括脉管癌栓、盆腔淋巴结转移、宫旁浸润、阴道切缘阳性、卵巢转移)并进行统计学分析。结果TAC组和TACE组的肿瘤缓解情况、肿瘤缩小率和术中出血量均优于全身化疗组(P<0.05);TAC组和TACE组间差异无统计学意义。TACE组的脉管癌栓和淋巴结转移发生率低于另外2组,但差异无统计学意义。3组病例在宫旁浸润、阴道切缘阳性、卵巢转移等因素和化疗后不良反应方面差异无统计学意义。结论对于Ⅰb2～Ⅱb期宫颈鳞状细胞癌,术前TAC和TACE优于全身化疗。与TAC相比,TACE有望减少脉管癌栓、盆腔淋巴结转移等预后不良因素的发生。
Objective To compare the short-time effect of 3 different regimens of neoadjuvant chemotherapy（NACT） in patients with FIGO stage Ⅰb2—Ⅱb cervical squamous carcinoma.Methods A total of 50 patients with FIGO stage Ⅰb2—Ⅱb cervical squamous carcinoma were divided into 3 groups： systemic chemotherapy group（n=13）,trans-arterial chemotherapy group（TAC,n=19）,trans-arterial chemoembolization group（TACE,n=18）.After 1—3 periods of NACT,all patients received surgical operation.Tumor response and reduction ratio after NACT,side effects,hemorrhage volume in surgery and bad prognostic factors（including intraluminal tumor thrombi,pelvic lymph node metastasis,parametrial involvement,positive surgical margin,ovary metastasis） of operation sample were statistically analyzed.Results Tumor response,reduction ratio and hemorrhage volume in surgery were significantly better in TAC group and TACE group than those in systemic chemotherapy group（P0.05）,but no significant difference was found between TAC group and TACE group（P0.05）.The incidence rate of intraluminal tumor thrombi and lymph node metastasis was lower in TACE group than in systemic chemotherapy group and TAC group,but there was no statistical difference.No difference of parametrial involvement,positive surgical margin,ovary metastasis and side effects was found among 3 groups.Conclusion For stage Ⅰb2—Ⅱb cervical squamous carcinoma,preoperative TAC and TACE have more advantages than systemic chemotherapy.In comparison with TAC,TACE is expected to reduce the incidence rate of bad prognostic factors such as intraluminal tumor thrombi and pelvic lymph node metastasis.
出处
《中国介入影像与治疗学》
CSCD
2010年第2期133-136,共4页
Chinese Journal of Interventional Imaging and Therapy
关键词
癌
鳞状细胞
宫颈
新辅助化疗
Carcinoma
squamous cell
Cervix uteri
Neoadjuvant chemotherapy
