术前新辅助化疗治疗宫颈癌62例的疗效观察  

Clinical curative effects of preoperative neoadjuvant chemotherapy on cervical cancer： analysis of 62 patients

作　　者：何超蔓[1] 梁峰冰[2] 陈曼玲[1] 吴小妹[1] 金松[1] 

机构地区：[1]海南医学院附属医院妇产科,海口市570102 [2]浙江大学医学院附属邵逸夫医院妇产科

出　　处：《中华医学杂志》2012年第5期327-329,共3页National Medical Journal of China

摘　　要：目的 观察术前新辅助化疗治疗局部晚期宫颈癌患者的治疗效果.方法 2006年8月至2010年7月选择紫杉醇联合顺铂化疗方案对海南医学院附属医院62例Ⅰh2～Ⅱb期宫颈癌患者进行2～3个疗程的新辅助化疗,通过观察患者病灶大小的改变、手术情况和术后病理反应等对治疗效果进行评价.结果 化疗后总有效率为90.32％ （56/62）,完全缓解30.65％ （19/62）.肿瘤直径较化疗前有不同程度缩小,差异有统计学意义（P＜0.05）.有效的56例患者化疗疗程结束后顺利完成宫颈癌根治术,手术切除率为90.32％.在术后切除的标本中见癌组织周围明显化疗反应和大量淋巴细胞浸润者50例,术后淋巴结阳性者3例,宫旁浸润者2例,脉管癌栓者2例.结论 术前新辅助化疗治疗宫颈癌可以缩减局部肿瘤病灶,宫旁组织弹性变软,降低肿瘤的分期,提高手术治疗效果.Objective To explore the clinical curative effects of preoperative neoadjuvant chemotherapy （NACT） on locally advanced cervical cancer.Methods A total of 62 patients of stage Ⅰ b2-Ⅱ b cervical cancer received neoadjuvant chemotherapy of paclitaxel plus cisplatin for 2-3 courses.The clinical curative effects were evaluated according to the changes of lesion size,intraoperative conditions and postoperative pathological reactions.Results The overall response rate was 90.32% （56/62） and the complete response rate 30.65% （19/62）.The tumor volumes decreased after NACT.The differences were significant （P 〈 0.05）.After NACT,56 patients undergoing radical hysterectomy recovered smoothly.The surgical resection rate was 90.32%.Chemotherapeutic reactions of cancerous tissue and a large number of infiltrated lymphocytes were seen in 50 cases.Lymph nodes were positive in 3 cases.There were parametrial invasion （ n =2） and vascular tumor emboli （n =2）.Conclusion Preoperative neoadjuvant chemotherapy is efficacious in cervical cancer.The parametrium becomes softer and the tumor staging decreases.

关 键 词：子宫肿瘤 紫杉酚 顺铂 

分 类 号：R737.33[医药卫生—肿瘤]