动脉与静脉新辅助化疗联合手术治疗局部晚期宫颈癌疗效研究  

A study of efficacy of neoadjuvant arterial and venous chemotherapy combined with surgery for locally advanced cervical cancer

作　　者：赵辉[1] 何玥[1] 朱丽荣[2] 王益勤 姚颖[4] 吴玉梅[1] Zhao Hui;He Yue;Zhu Lirong;Wang Yiqin;Yao Ying;Wu Yumei(Department of Gynecologic Oncology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing,Beijing 100006,China;不详)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院妇科肿瘤科,100006 [2]北京大学第一医院妇产科,100035 [3]北京大学人民医院妇产科,100044 [4]北京大学第三医院妇产科,100191

出　　处：《疑难病杂志》2024年第7期798-802,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：北京市医院管理中心临床医学发展专项经费资助(ZYLX201705)。

摘　　要：目的探讨动脉与静脉2种给药途径的新辅助化疗(NACT)对局部晚期宫颈癌患者化疗效果的影响。方法回顾性收集2009年1月1日—2016年12月31日在首都医科大学附属北京妇产医院、北京大学人民医院、北京大学第一医院、北京大学第三医院、北京朝阳医院、北京安贞医院、北京世纪坛医院共7家北京地区三甲医院入院接受NACT联合宫颈癌根治术(RH)治疗的ⅠB2/ⅡA2期(FIGO2009)宫颈癌患者178例的临床病历资料并进行分析。按不同化疗方案分为动脉给药组104例和静脉给药组74例,比较2组患者术后病理高危因素及临床结局差异,以及化疗后骨髓抑制程度的差异。结果动脉给药组化疗后总有效率与静脉给药组比较差异无统计学意义(P>0.05),而淋巴结转移率低于静脉给药组(χ^(2)/P=6.311/0.010)。动脉给药组化疗后血红蛋白低于静脉给药组,骨髓抑制程度轻于静脉给药组(t/χ^(2)=2.864、2.299,P=0.005、0.022)。动脉给药组根治术后仍需补充放疗的比例低于静脉给药组(χ^(2)=8.029,P=0.003)。结论在局部晚期宫颈癌患者中,动脉化疗在减少术后病理高危因素及术后补充放疗率方面,具有潜在优势。Objective To investigate the effect of neoadjuvant chemotherapy(NACT)by arterial and intravenous route on chemotherapy in patients with locally advanced cervical cancer.Methods The clinical data of 178 patients with cervical cancerⅠB2/ⅡA2(FIGO2009)who were received NACT combined with radical cervical cancer(RH)treatment and admitted to seven first-class hospitals from January 1,2009 to December 31,2016 were collected from the Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Peking University People's Hospital,Peking University First Hospital,Peking University Third Hospital,Beijing Chaoyang Hospital,Beijing Anzhen Hospital and Beijing Shijitan Hospital.The patients were divided into arterial group(104 cases)and intravenous administration group(74 cases)according to different chemotherapy regimences.To compare the difference of pathological high-risk factors and clinical outcomes between the two groups,and the difference of bone marrow suppression degree after chemotherapy.Results There was no significant difference in the total effective rate between the arterial group and the intravenous administration group(P>0.05),while the lymphatic metastasis rate in arterial administration group was lower than that of the intravenous administration group(χ^(2)/P=6.311/0.010).The hemoglobin in arterial administration group was lower than that of the intravenous administration group,and the degree of bone marrow suppression in the arterial administration group was lower than that in the intravenous administration group(t/χ^(2)=2.864,2.299,P=0.005,0.022).The rate postoperative radiotherapy in arterial administration group was lower than that in intravenous administration group(χ^(2)=8.029,P=0.003).Conclusion In patients with locally advanced cervical cancer,arterial chemotherapy has potential advantages in reducing postoperative pathological risk factors and the rate of postoperative supplementary radiotherapy.

关 键 词：局部晚期宫颈癌 新辅助化疗 给药途径 同步放化疗 

分 类 号：R737.33[医药卫生—肿瘤]