ⅠB～ⅡA期宫颈癌新辅助化疗的疗效评估  

Neoadjuvant chemotherapy followed by radical hysterectomy in StageⅠB-ⅡA cervical cancer

作　　者：李琳[1] 毛小刚[1] 邢辉[1] 

机构地区：[1]襄阳市中心医院妇产科,湖北襄阳441021

出　　处：《西部医学》2014年第5期558-560,共3页Medical Journal of West China

基　　金：湖北省卫生厅青年人才基金(QJX2008-61)

摘　　要：目的 评价根治术前给予新辅助化疗对Ⅰ B-ⅡA期巨块型宫颈癌患者的临床疗效及安全性.方法 选取59例ⅠB-ⅡA期巨块型宫颈癌癌患者,其中ⅠB期29例,ⅡA期30例.病理类型：鳞癌52例,腺癌7例.新辅助化疗采用以“紫杉醇＋奈达铂”联合化疗.化疗后56例行子宫广泛根治术及盆腔淋巴清扫术,3例化疗无效而行放疗.接受手术者中有8例因淋巴结转移术后追加放射治疗.结果 患者的手术时间为2-6h,平均时间（4.2±0.8）h,手术中出血量为200-1000ml,平均出血量（480±67）ml;化疗总有效率89.9％（53/59例）,5例肿瘤完全消退（8.4％）,其中4例术后病理标本中未见残留癌,47例部分缓解（79.6％）.Ⅲ、Ⅳ级骨髓抑制白细胞减少发生率为18.6％（11/59例）11.9％（7/59例）;ⅠB期患者化疗有效率为96.9％,ⅡA期患者化疗有效率为80.7％,ⅠB期患者化疗有效率明显高于ⅡA期患者（P＜0.05）;所有患者化疗期间均没有出现明显的毒副作用及并发症.结论 ⅠB-ⅡA期巨块型宫颈癌在根治术前给予联合化疗能使肿瘤缩小,宫旁组织浸润消退,为根治性手术创造条件.Objective To evaluate the efficacy and safety of neoadjuvant chemotherapy followed by radical hysterectomy in stage Ⅰ B - Ⅱ A cervical cancer.Methods 59 patients staged at Ⅰ B--Ⅱ A were treated with preoperative chemotherapy.Pathological classification included 52 cases of squamous carcinoma and 7 cases of adenocarcinoma.Radical hysterectomy and pelvic lymphadenectomy were performed after neoadjuvant chemotherapy in 56 patients.Post-operative irradiation was added to 8 patients with positive pelvic node.Results Clinical response were observed in 59 patients with five complete and 47 partial,pathologically complete response were seen in 5.Neoadjuvant therapy was well-tolerated with neutropeuia Grade 3 and 4 in 18.6％（11/59）and 11.9％（7/59）patients,respectively.Conclusion Preoperative intraarterial infusion as neoadjuvant chemotherapy is effective in cervical and parametrical regression.

关 键 词：宫颈癌 新辅助化疗 宫颈癌根治术 

分 类 号：R711.71[医药卫生—妇产科学]