不同方式新辅助化疗在宫颈鳞癌中的疗效观察  

Comparison of therapeutic effects between different types of neoadjuvant chemotherapy on squamous cell carcinoma of cervix

作　　者：方伟达[1] 韩懿[1] 何科[2] 牛刚[2] 

机构地区：[1]广东省开平市中心医院肿瘤科,广东开平529300 [2]中山大学附属第一医院妇科,广东广州510080

出　　处：《中国现代医生》2012年第16期26-28,共3页China Modern Doctor

摘　　要：目的探讨不同方案的新辅助化疗对局部晚期或巨块形Ⅰb～Ⅲa期宫颈癌的治疗的疗效。方法回顾性研究2002～2006年我院185例Ⅰb～Ⅲa宫颈鳞状上皮癌患者,按新辅助化疗方式分为三组,组1:动脉灌注卡铂,组2:动脉灌注卡铂+紫杉醇,组3:静脉滴注卡铂+紫杉醇;随后行根治性手术,术后随访5年。比较各组间疗效、淋巴结转移率及生存时间。结果化疗疗效情况:组1与组2之间差异无统计学意义,而两组与组3之间差异有统计学意义;组1、2较组3新辅助化疗术后宫旁累及淋巴结转移相比,差异有统计学意义(P<0.05);三组复发率分别是1.78%、0、4.47%,三组间差别无统计学意义。结论 3种新辅助化疗对于局部晚期宫颈癌能有效缩小肿瘤体积、提高手术切除率、降低复发转移;卡铂单药动脉灌注化疗方案是对宫颈鳞癌新辅助化疗有效的方案。Objective To compare the therapeutic effect between different types of neoadjuvant chemotherapy on bulky or locally advanced cervical cancer. Methods A retrospective study was carried out on 185 patients with stage I b-Ⅲa cervi- cal squamous cell carcinoma admitted to our hospital from 2002 to 2006. The patients were divided into 3 groups accord- ing to the types of neoaduvant chemotherapy, group 1： carboplatin intra-arterial infusion;group 2： carboplatin＋ paclitaxel intra-arterial infusion; group3： earboplatin＋paclitaxel intra-venous infusion. All patients received operation after chemother- apy and were followed up for 5 years. There were no significant difference between the 3 groups in age, FIGO stage or pathol- ogy （P 〉 0.05）. Results Staitsical index includes multiple prognosis factors such as parametrial involvement, lymphatic metastasis, surgical margin, side effect, recession rate and survival rate. There were significant differene in parametrial in- volvement （P 〈 0.05）, lymphatic metastasis （P 〈 0.05） and tumor size 〈0.002）. There were no significant difference in side effect, surgical margin. The recurrence rate in 3 groups were 1.78%, 0, 4.47% respectively. Conclusion Three program of neoadjuvant chemotherapy were safe and effective for locally advanced cervical cancer, reduced the relapse and metastasis. Single agent of carboplatin intra-arterial infusion is effective on sauamous cell carcinoma of cervix.

关 键 词：子宫颈鳞癌 新辅助化疗 卡铂 紫杉醇 

分 类 号：R737.33[医药卫生—肿瘤]