摘要
目的探讨术前新辅助化疗对局部晚期宫颈癌的近期疗效。方法以29例Ib2~Ⅱb期局部晚期宫颈癌为NACT观察组,予PBV方案或TP方案化疗1~2个疗程,随后行根治性手术;以28例同期同条件患者直接行根治性手术为手术对照组。比较NACT观察组化疗前后肿瘤大小变化、两组间手术时间和出血量以及两组术后宫颈深间质层浸润、脉管癌栓、淋巴结转移情况,同时观察新辅助化疗的毒副反应及评价新辅助化疗的安全性。结果 NACT观察组中完全缓解4例,部分缓解19例,稳定4例,进展1例,临床有效率为79.31%;NACT观察组化疗前后肿瘤最大直径比较显著性缩小,P<0.05;NACT观察组和对照组的手术时间分别为(196.46±30.29)min和(287.56±49.43)min,P<0.05;NACT观察组和对照组的术中出血量分别为(579.96±217.45)mL和(829.62±237.16)mL,P<0.05;NACT观察组与手术对照组的宫颈深层间质浸润发生率分别为51.72%、64.28%,P>0.05;脉管癌栓发生率分别为27.59%、25.00%,P>0.05;淋巴结转移率分别为20.07%、35.14%,P>0.05。结论局部晚期宫颈癌术前新辅助化疗可缩小肿瘤体积、缩短手术时间、减少术中出血量、降低淋巴结转移率,提高近期疗效。
Objective To determine the effects of neoadjuvant chemotherapy on locally advanced cervical cancer.Methods 29 cases with locally advanced stage Ib2~Ⅱb cervical cancer were chosen as the experimental group.They received 1 to 2 courses of chemotherapy consisting of PVB or TP scheme,and radical surgery would be followed.A group of 28 cases with the same diagnoses who received radical surgery alone were chosen as the control group.The immediate therapeutic effects,pathology results and toxicity were observed to evaluate the effect and security of NACT.Results In experimental group,the rate of response was 79.31%(4 cases were complete remission,19 cases were partial remission,4 cases were stable disease and 1 case was progressive disease),and the diameters of the masses of cancer were decreased noticeably(P0.05)after the treatment of chemotherapy;Surgery time and the volume of bleeding at surgery and lymph nide metastasis were significantly decreased(P0.05).Conclusion Neoadjuvant chemotherapy (NACT) on locally advanced cervical cancer can diminish the volume of tumors and reduce the surgery time and bleeding which makes the surgery easier and safer.It seems to improve short-time survival rate.
出处
《重庆医学》
CAS
CSCD
北大核心
2010年第12期1559-1560,1563,共3页
Chongqing medicine
关键词
新辅助化疗
宫颈癌
手术
cercix neoplasms
neoadjuvant chemotherapy
surgery