两种不同途径新辅助化疗治疗局部晚期子宫颈癌的对比分析  

The comparative analysis of neoadjuvant chemotherapy by two ways for locally advanced cervical cancer

作　　者：孙光伟[1] 袁敏[1] 程静新[1] 古力米热.乃扎尔 杨树法[2] 刘墨[2] 阿依帕夏[1] 

机构地区：[1]新疆医科大学附属肿瘤医院妇外三科,新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院介入科,新疆乌鲁木齐830011

出　　处：《新疆医科大学学报》2011年第4期347-350,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金项目(项目编号:2010211A31);乌鲁木齐市人才工程专项基金项目(项目编号:P07131003)

摘　　要：目的比较两种不同途径的新辅助化疗在ⅠB2~ⅡB期局部晚期宫颈癌治疗中的临床疗效,以期更好的指导临床。方法分析新疆医科大学附属肿瘤医院2008年2月~2009年12月治疗的142例ⅠB2~ⅡB期局部晚期宫颈癌患者的临床资料,根据化疗的途径不同分为两组,静脉化疗组和超选择子宫动脉灌注化疗组（以下简称静脉组和动脉组）,其中静脉组68例,动脉组74例,化疗结束后2周左右,结合妇科检查、影像学检查,进行疗效评价。结果化疗总有效率67.6%,其中静脉组64.7%,动脉组70.3%,两组比较,差异无统计学意义（P〉0.05）。两组宫旁改善情况比较差异有统计学意义（P〈0.05）,表明超选择动脉灌注化疗较静脉能更好的改善宫旁条件;动脉化疗毒副反应较静脉少,但静脉组恢复时间较长。术后病理组织情况两组比较均无统计学意义（P〉0.05）。结论静脉化疗和超选择子宫动脉灌注化疗均为ⅠB2~ⅡB期局部晚期子宫颈癌新辅助化疗的有效途径,在临床治疗中应根据患者的具体情况选择合适的化疗途径,以得到更好的治疗效果。Objective To compare the therapeutical effect of venous and uterine arterial neoadjuvant chemotherapy on stage ⅠB2～ⅡB locally advanced cervical cancer,in order to direct the healing of clinic.Methods A retrospective study was carried out on 142 patients with FIGO stage ⅠB2～ⅡB locally advanced cervical cancer admitted to our hospital from Feb 2008 to Sept 2009.These patients were divided into two groups： venous chemotherapy（68 cases） and ultraselection uterine arterial interventional chemotherapy（74 cases）.After 2 weeks on the end of the last NACT,combined gynaecological check-up,pelvic imaging examinations,and evaluated the curative effect.The value of different NACT was evaluated by contrasted the effective rate,toxin and side effect,and the results of pathology.Results In the venous group,the effective rate was 64.7%,while the arterial group was 70.3%.The differences between them showed no significance（P0.05）.During neo adjuvant chemotherapy in arterial group the organization of the uterus was better than that in venous and those of with difference（P0.05）;the toxic and adverse effects and the time of recovering in uterine group were smaller than ultraselection uterine arterial interventional chemotherapy group.Two groups were almostly the same in pathology outcomes after operation（P0.05）.Conclusion Vnous and ultraselection uterine arterial interventional eoadjuvant chemotherapy are efficient in stage ⅠB2-ⅡB locally advanced cervical cancer.We should select the correct one on the basis of the patients′ characteristics,by this way we would get a better therapeutic effect in clinical application.

关 键 词：局部晚期宫颈癌 新辅助化疗 静脉 动脉灌注 近期疗效 

分 类 号：R737.33[医药卫生—肿瘤]