术前新辅助化疗在ⅠB2、ⅡA2期巨块型宫颈癌治疗中的临床研究  

Clinical study of preoperative neoadjuvant chemotherapy in the treatment of stage ⅠB2 and ⅡA2 bulky cervical cancer

作　　者：刘萍[1] 潘九林[1] 尹香花[1] 

机构地区：[1]江苏省苏北人民医院,江苏扬州225001

出　　处：《临床医学研究与实践》2017年第3期3-5,共3页Clinical Research and Practice

摘　　要：目的探讨术前新辅助化疗在早期巨块型宫颈癌治疗中的应用效果。方法选择我院行手术治疗的巨块型宫颈癌患者165例,根据患者术前是否行新辅助化疗,将患者分为新辅助化疗组和直接手术组。观察新辅助化疗组患者新辅助化疗的总有效率,比较两组患者术中出血、手术时间、并发症、术后病理等情况,并对术后病理危险因素进行比较。结果两组患者手术时间、术中出血及手术并发症无明显差异(P>0.05)。新辅助化疗组中,ⅠB2期患者的CR、PR分别为12.8%、78.7%,总有效率为91.5%;ⅡA2期患者的CR、PR分别为7.9%、76.3%,总有效率为84.2%。新辅助化疗组脉管癌栓、淋巴结转移、宫旁浸润为25.9%、16.5%、9.4%,与直接手术组的40.0%、32.5%、20.0%相比,差异有统计学意义(P<0.05)。结论紫杉醇^+顺铂新辅助化疗能缩小癌肿病灶,降低手术分期,降低术后病理预后危险因素,减少术后辅助放化疗的比率。Objective To evaluate the effect of preoperative neoadjuvant chemotherapy in the treatment of early bulky cervical cancer. Methods One hundred and sixty-five patients with bulky cervical cancer treated with neoadjuvant chemotherapy in our hospital were selected and divided into neoadjuvant chemotherapy group and direct surgery group, according to whether preoperative neoadjuvant chemotherapy was performed. The total response rate of neoadjuvant chemotherapy in the neoadjuvant chemotherapy group was observed, and the conditions of bleeding, operation time, complications, postoperative pathology and pathological risk factors were compared in the two groups. Results There was no significant difference between the two groups in operation time, intraoperative bleeding and operation complications （P〉 0.05）. In the neoadjuvant chemotherapy group, CR and PR of the patients with stage IB2 bulky cervical cancer were 12.8% and 78.7% respectively, and the total effective rate was 91.5%; while CR and PR of the patients with stage IIA2 bulky cervical cancer were 12.8% and 78.7% respectively, and the total effective rate was 91.5%. Vascular tumor thrombus, lymph node metastasis, uterine infiltration were 25.9%, 16.5%, 9.4% respectively in the neoadjuvant chemotherapy group, compared with 40.0%, 32.5% and 20% in the direct surgical group, the difference was statistically significant （P〈0.05）. Conclusion Noadjuvant chemotherapy of paclitaxel and csplatin can reduce the tumor lesions, reduce the surgical staging, postoperative pathology prognostic risk factors and the rate of postoperative adjuvant radiotherapy and chemotherapy.

关 键 词：宫颈癌 新辅助化疗 紫杉醇 

分 类 号：R737.33[医药卫生—肿瘤]