动静脉不同途径新辅助化疗对年轻局部晚期宫颈癌术后患者卵巢功能的影响  

Effect of Neoadjuvant Chemotherapy via Different Arteriovenous Ways on Ovarian Function in Young Patients with Locally Advanced Cervical Cancer Post Surgery

作　　者：陈滢[1] 王晶[1] 杨赛花[1] 童明[1] 

机构地区：[1]广州军区武汉总医院妇产科,武汉430070

出　　处：《医药导报》2015年第3期344-346,共3页Herald of Medicine

摘　　要：目的评价年轻局部晚期宫颈癌术前动脉、静脉不同途径新辅助化学治疗（化疗）对术后卵巢功能的影响。方法采用回顾性研究,确诊为局部晚期子宫颈鳞状细胞癌并行宫颈癌根治术且术中保留双侧卵巢的年轻（手术年龄〈45岁）女患者38例,按照新辅助化疗途径分为A组（动脉介入栓塞化疗）20例,B组（静脉化疗）18例,每例均进行一疗程TP方案化疗[注射用紫杉醇脂质体135-175 mg·（m^2）^-1,顺铂50 mg·（m^2）^-1],术后行3个周期BOMP化疗。回顾性分析比较两组手术前后血清雌二醇（E2）、卵泡刺激素（FSH）、黄体生成素（LH）变化以评估卵巢功能。分别比较两组化疗前、化疗后2-3周（术前）、术后1个月及术后6个月的E2、FSH及LH水平。结果 A组化疗后2-3周（术前）及术后1个月E2水平较化疗前下降,FSH升高,差异有统计学意义（P〈0.05）,B组各激素在不同时点比较均差异无统计学意义（P〉0.05）,两组LH在不同时点及两组术后6个月与化疗前比较均差异无统计学意义（P〉0.05）。A组术前E2水平明显低于B组,其余两组间差异无统计学意义（P〉0.05）。随访中,无一例因卵巢转移复发。结论年轻局部晚期宫颈癌患者术前行动脉介入栓塞化疗对卵巢功能的影响是短暂、可逆的,术前静脉化疗对卵巢功能几无影响,宫颈癌根治术中保留双侧卵巢是保护年轻局部晚期宫颈癌患者内分泌功能安全有效的方法。Objective To evaluate the effect of neoadjuvant chemotherapy by different arteriovenous ways on ovarian function of patients with locally advanced cervical cancer after surgery. Methods We retrospectively studied 38 cases of young women （surgical age 〈45 years） who were diagnosed with locally advanced squamous cell carcinoma of the cervix and undergone radical hysterectomy with ovaries. According to the way of adjuvant chemotherapy, these cases were divided into 20 cases of group A （arterial embolization chemotherapy）, 18 cases of group B （intravenous chemotherapy）. Each patient underwent a course of chemotherapy. Then we retrospectively analyzed and compared serum estradiol （E2 ）, follicle stimulating hormone （FSH）, lute-inizing hormone （LH） in two groups before and after surgery to assess ovarian function. We compared E2 ,FSH and LH levels 2-3 weeks after chemotherapy （before surgery） and 1 month after surgery,and 6 months after surgery in two groups. Results The E2 levels in group A 1 month before and after surgery significantly decreased, while FSH increased compared with those be-fore chemotherapy（P〈0. 05）. LH levels in two groups at different time points and 6 months after surgery showed no significant difference （P〉0. 05） compared with those before chemotherapy. the E2 , FSH and LH levels in group B at different time points presented no significant difference （P〉0. 05）. Only E2 level in group A was significantly lower than that in group B before surger-y. Conclusion For patients with locally advanced cervical cancer, the effect of arterial embolization chemotherapy before sur-gical intervention on ovarian function is transient and reversible, while intravenous chemotherapy before surgery exerts few effects on ovarian function. Retaining ovaries in radical hysterectomy is a safe and effective method to protect the endocrine function for young patients with locally advanced cervical cancer.

关 键 词：新辅助化疗 癌 宫颈 晚期/局部 卵巢功能 

分 类 号：R979.1[医药卫生—药品] R737[医药卫生—药学]