Ⅰb2～Ⅱb期宫颈腺癌患者术前新辅助化疗的疗效观察  

Effects of neoadjuvant chemotherapy in patient with stage Ⅰb2-Ⅱb adenocarcinoma of the uterine cervix

作　　者：叶春萍[1] 余宁珠[1] 

机构地区：[1]南京医科大学附属南京市妇幼保健院,江苏南京210004

出　　处：《现代医学》2012年第5期562-565,共4页Modern Medical Journal

摘　　要：目的:探讨术前新辅助化疗对Ⅰb2～Ⅱb期宫颈腺癌患者的疗效。方法:以Ⅰb2～Ⅱb期宫颈腺癌患者23例为观察组,予紫杉醇联合顺铂(TP方案)化疗1～2个疗程,随后行根治性手术;以19例同期同条件患者为对照组,直接予根治性手术。术后随访,观察两组患者的病理检查结果、预后情况及观察组患者的化疗有效率。结果:观察组患者化疗有效率为69.57%,宫颈深肌层浸润率、宫旁浸润率、盆腔淋巴转移率、阴道切缘率及术中出血量、肿瘤复发率均低于对照组(均P<0.05),1、3年生存率均高于对照组(P<0.05),两组手术时间比较差异无统计学意义(P>0.05)。结论:紫杉醇加顺铂方案是Ⅰb2～Ⅱb期宫颈腺癌患者术前新辅助化疗的有效方案,可缩小肿瘤体积,降低淋巴结转移率及复发率,延长患者生存时间。Objective： To determine the effects of neoadjuvant chemotherapy in patient with stageⅠb2-Ⅱb adenocarcinoma of the uterine cervix.Methods： 23 patients with stageⅠb2-Ⅱb adenocarcinoma of the uterine cervix were chosen for the observed group.They received 1 or 2 courses of treatment consisting of cisplatin and paclitaxel（TP regimen）.After the chemotherapy regimen was completed,the patients underwent radical surgery.A group of 19 cases with the same diagnoses received radical surgery alone.This group was considered the control group.The patients were followed.The pathology result,the rate of recurrence and the survival time were compared between the two groups.Results： The effective rate of chemotherapy for patients in the observed group was 69.57%.In the observed group,the postoperative rate of cervical deep myometrial invasion,parametrial infiltration rate,pelvic lymph node metastasis rate and vaginal margin rate were significantly lower compared to the control group（P0.05）.There was no difference in operative time of the two groups,but blood loss of the observed group were significantly less than the controls（P0.05）.The 1-year/3-years survival rate of the observed group were significantly longer than the controls,and the relapse rate were significantly lower for patients in the observed group.Conclusion： Neoadjuvant chemotherapy is beneficial for diminishing gross tumor volume,reducing the rate of lymph node metastasis and relapse and prolonging the survival time of patients with stageⅠb2-Ⅱb adenocarcinoma of the uterine cervix.The TP regimen is effective in the treatment of patient with stageⅠb2-Ⅱb adenocarcinoma of the uterine cervix.

关 键 词：宫颈腺癌 新辅助化疗 紫杉醇 顺铂 

分 类 号：R737.33[医药卫生—肿瘤]