新辅助介入化疗对巨块型子宫颈癌的疗效观察  

The analysis of effect of preoperative chemotherapy on bulky cervical cancer by internal illiac arterial infusion

作　　者：纪燕琴[1] 黄凤英[1] 

机构地区：[1]广东省惠州市中心人民医院妇产科,516001

出　　处：《肿瘤研究与临床》2006年第12期824-826,共3页Cancer Research and Clinic

摘　　要：目的观察新辅助介入化疗对巨块型子宫颈癌的作用。方法对1999年1月至2004年12月收治的126例巨块型子宫颈癌患者,随机分为2组,介入组74例,采用Seldinger技术髂内动脉插管注药。鳞癌采用顺铂+博莱霉素+长春新碱(PVB)方案,腺癌采用顺铂+多柔比星+长春新碱(PAB)方案。放疗组52例,按照宫颈癌放疗常规用6MeV加速器行全盆腔体外照射,总剂量24Gy,中间档野后继续照25Gy,穿插192Ir后装腔内放疗,每周2次,每次A点剂量5Gy,总剂量40Gy。两组患者术后2周决定下一步治疗。结果介入化疗组肿块消退(CR)12例(12/74),占16.21%,肿块缩小≥50%(PR)57例(57/74),占77.02%。适宜Ⅱ期手术67例(67/74),占90.54%;放疗组CR6例(6/52),占11.53%;PR31例(31/52),占59.61%。适宜Ⅱ期手术37例,占71.15%(37/52)。两组比较,PR、2期手术率差异有统计学意义。介入化疗2年复发率6%,3年复发率8%;放疗组2年复发率8%,3年复发率23%;介入组3年总生存率79%,放疗组3年总生存率71%。两组2年复发率与3年总生存率比较,无统计学意义(P>0.05);3年复发率差异有统计学意义(P<0.05)。结论新辅助介入化疗可有效缩小肿瘤,增加Ⅱ期手术率,减少3年复发率,能否减低5年复发率、增加5年生存率,有待进一步随访。Objective To investigate the therapeutic effect of arterial interventional chemotherapy on bulky cervical cancer. Methods One hundred and twenty-six patients with bulky cervical cancer were randomly divided into two groups. Arterial interventional chemotherapy group（n =74, C gronp）, and radiotherapy group （n =52 R group）. Patients in C group underwent internal iliac arterial infusion chemotherapy by using Seldinger technique. The chemotherapy regimens of cervical squamous cell carcinoma were prescribed including cisplatin and BLM, and cervical adenocarcinoma were prescribed including cisplatin and ADM and VCR. Patients in R group were only given radiotherapy Ir^192 high-dose rate intracavitary radiotherapy was performed with A point dose at 24 Gy. Both groups of patients were followed up after two weeks. Results The tumor regression rate of C group was 93.24 %, significantly higher than 71.15 % in R group（P 〈0.05）. The effective rate for clinical Ib stage cancer in C group was 97.96 %, significantly higher than 77.77 % in R group （P 〈 0.05）. The rate of surgery after chemotherapy was 90.54 % in C group, significantly higher than 71.15 % in R group. The 2-year recurrence rate was 6 % and 3-year recurrence rate was 8 % in C group, and those of R groups were 8 %, 23 %. The 2-year recurrence rate between the two groups had no obvious difference （P 〉 0.05）. The 3-year recurrence rate between the two groups had obvious difference（P 〈0.05）. The total 3-year survival rate of C group were 79 %, and those of R group were 71%, without significant difference（P 〉0.05）. Conclusion Neoadjuvant chemotherapy can effectively reduce tumor volume, and postoperative 3-year re- currence rate, increases surgery rate on bulky cervical cancer. But the effect on long-term survival rate needs to be evaluated further through long-term follow-up.

关 键 词：新辅助介入化疗 子宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]