中国大陆34家医院ⅠB2、ⅡA2期宫颈癌新辅助化疗不同方案的近期疗效对比  

Clinical effect of neoadjuvant chemotherapy for FIGO stage ⅠB2 and ⅡA2 cervical carcinoma: short-termresults of 34 hospitals in China's Mainland

作　　者：林善群 Zeinab Yusuf Ali 王璐[2] 霍智锋[2] 陈春林[2] 康山 王武亮[4] 朱前勇 倪妍 陆安伟 李东林[8] 刘萍[2] 郎景和[9] LIN Shan- qun;Zeinab Yusuf Ali;WANG Lu;HUO Zhi-feng;CHEN Chun-lin;KANG Shan;WANG Wu-liang;ZHU Qian-yong;NI Yan;LU An-wei;LI Dong-lin;LIU Ping;LANG Jing- he(Department of Obstetrics and Gynecology, Yangchun People＇s Hospital, Yangjiang 529600, China;Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China)

机构地区：[1]阳春市人民医院妇产科,广东阳江529600 [2]南方医科大学南方医院妇产科,广东广州510515 [3]河北医科大学第四医院妇产科,河北石家庄050011 [4]郑州大学第二附属医院妇产科,河南郑州450014 [5]河南省人民医院妇产科,河南郑州450003 [6]运城市中心医院妇产科,山西运城044000 [7]贵州省妇幼保健院妇产科,贵州贵阳550003 [8]贵州省人民医院妇产科,贵州贵阳550012 [9]中国医学科学院北京协和医院妇产科,北京100730

出　　处：《中国实用妇科与产科杂志》2018年第7期793-798,共6页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：十二五国家科技支撑计划(2014BAI05B03);国家自然科学基金(81272585;81370736;81571422);广州市科技计划(158100075);南方医科大学高水平建设临床研究重点项目(LC2016ZD019)

摘　　要：目的探讨ⅠB2、ⅡA2期宫颈癌新辅助化疗不同方案的近期疗效差异。方法回顾性分析2004—2016年中国大陆34家医院30 665例宫颈癌病例,筛选术前活检确诊、FIGO分期ⅠB2及ⅡA2期、新辅助化疗+手术治疗、资料完整的1064例患者,根据化疗方案,分为紫杉醇类+顺铂(TP)组(A组)、紫杉醇类+非顺铂铂类(TC)组(B组)、顺铂+其他药物组(C组)、非顺铂铂类+其他药物组(D组),以妇科检查结合影像学检查评估新辅助化疗前后局部病灶大小的变化,比较不同化疗方案近期疗效差异。结果 (1)四组方案新辅助化疗有效率71.43%(280/392)、62.54%(187/299)、64.31%(200/311)、67.74%(42/62),差异无统计学意义(P>0.05)。(2)2009年以前C+D组化疗方案比例均超50.00%,此后A+B组比例上升;比较C、D组,C组方案在不同时间比例均超52.00%;比较A、B组,2013年前A方案比例高于B方案,此后,B方案比例达61.11%,并呈上升趋势。结论 (1)ⅠB2、ⅡA2期宫颈癌患者采用四组常见方案新辅助化疗效果均理想,近期疗效相似。(2)化疗方案呈现出随时间变化的趋势:2009年以前,铂类+非紫杉醇类药物方案是主流方案,其中顺铂使用最广泛;2009年以后紫杉醇类+铂类方案开始广泛应用,其中2013年以前TP方案是主流,2013年后,TC方案逐渐超过TP方案成为主流。Objective To investigate the short-term curative effect of neoadjuvant chemotherapy for FIGO stage ⅠB2 and ⅡA2 cervical carcinoma.Methods A retrospective analysis was performed in 30 665 cases of cervical cancer in 34 hospitals in parts of China's Mainland from 2004 to 2016.Totally 1064 cases were selected according to the following criteria：being confirmed by preoperative biopsy,FIGO stageⅠB2 andⅡA2,receiving neoadjuvant chemotherapy plus surgery and having intact clinical records.They were divided into group A（cisplatin plus paclitaxel,TP）,group B（non-cisplatin platinum compound plus taxane,TC）,group C（cisplatin plus other regimens）,and group D（non-cisplatin plus other regimens）,according to different chemotherapy regimens.Changes of local lesion size before and after neoadjuvant chemotherapy were estimated by vaginal and imaging examination and were compared to evaluate the short-term effects of different chemotherapy regimens. Results（1）Effective rates of the four groups were 71.43%（280/392）,62.54%（187/299）,64.31%（200/311）and 67.74%（42/62）,respectively,but there were no significant differences（P〈0.05）（.2）Before 2009,C＋D chemotherapy regimens were over 50.00%. After that,the use of A＋B regimens tended to increase gradually. Comparing C with D group,the proportion of C regimens was over 52.00%.Comparing A with B group,before 2013,the proportion of A was higher than B. The use of B accounted for 61.11% in 2013 and went on rising after that.Conclusion（1）Effective rates of TP,TC,cisplatin plus other regimens and platinum plus other regimens used as neoadjuvant chemotherapy for FIGO stage ⅠB2 and ⅡA2 of cervical cancer are ideal and similar（.2）A time-dependent trend is found in neoadjuvant chemotherapy for cervical cancer：before 2009,platinum plus other combination chemotherapy regimens（mainly cisplatin）was in the majority. After 2009,chemotherapy regimens of taxanes plus platinum were widely used,and TP regimen was in the majority. After

关 键 词：新辅助化疗 铂类 宫颈癌 近期疗效 

分 类 号：R737.3[医药卫生—肿瘤]