巨块型宫颈癌术前新辅助化疗的疗效观察(附60例分析)  

Efficiency of neoadjuvant chemotherapy in preoperative management of bulky cervical carcinoma

作　　者：郭慈仁[1] 陈桂林[1] 黄燕玲[1] 陈炜[1] 张风贞[1] 

机构地区：[1]福建省肿瘤医院妇科,福州350014

出　　处：《福建医药杂志》2011年第3期3-5,共3页Fujian Medical Journal

摘　　要：目的探讨巨块型宫颈癌术前新辅助化疗的治疗效果。方法对我院收治的6 0例Ⅰb~Ⅱa期巨块型宫颈癌进行回顾性分析,根据术前是否行新辅助化疗（Neoadjuvant Chemotherapy,NACT）分为两组,即NACT组和单纯手术对照组,各3 0例。NACT组术前行1~2个疗程以铂类为基础的联合化疗,化疗结束后2周行宫颈癌根治术。观察化疗后局部肿瘤退缩情况及化疗不良反应,并比较两组手术效果。结果 （1）NACT组化疗后肿瘤直径较化疗前明显缩小（P〈0.0 5）,总有效率为7 3.3%,近期不良反应轻;（2）NACT组的手术时间、术中出血量明显低于对照组（P〈0.0 5）,两组术后胃肠道功能恢复时间及膀胱功能恢复时间差异无计学意义（P〉0.0 5）;（3）NACT组术后高危病理因素发生率低于对照组,但差异无统计学意义（P〉0.0 5）。结论巨块型宫颈癌术前新辅助化疗可明显缩小原发灶,减少手术时间及出血量,且不影响患者术后恢复,临床上值得推广应用。Objective To investigate the efficiency of neoadjuvant chemotherapy（NACT）in preoperative management of bulky cervicai carcinoma.Methods Sixty cases of stage Ⅰb~Ⅱa cervical carcinoma patients were divided into two groups according to pre-operative chemotherapy：thirty cases in the NACT group who accepted 1~2 courses of platinum-based chemotherapy before surgery;and another thirty cases in the control group underwent radical surgery directly.The tumor volume was evaluated by gynecological examination before chemotherapy and two weeks after chemotherapy,and the complication of chemotherapy was observed at the same time.The surgical efficiency of two groups was compared at last.Results Tumor volume was significant reduced after chemotherapy,the overall effective rate was 73.3%,and the incidence of complication was quite low.The operation time and blood loss of NACT group were significant lower than those of control group（P0.05）,but there was no significant difference between the two groups about gastrointestinal function restoring time and bladder function restoring time（P0.05）.The rate of lymphatic metastasis,vessel invasion,deep stromal invasion and parametrial invasion in NACT group were lower than which in control group,while neither with statistical significance（P0.05）.Conclusion Preoperative neoadjuvant chemotherapy can reduce the primary tumor volume and benefit to the following radical operation,which is worth popularizing in clinical treatment.

关 键 词：宫颈肿瘤 巨块型 辅助化学疗法 

分 类 号：R737.33[医药卫生—肿瘤]