重组人P53腺病毒注射液联合化疗在早期巨块型宫颈癌术前治疗中的效果

摘要

Objective To contrast the effect of the rAd-P53-TP combination treatment and the TP single treatment be-fore the operation of the Ⅰb2-IIa stage bulky cervical carcinoma. Methods Sixty-five patients with the Ⅰb2-IIa stage bulky cervical carcinoma were treated in the First People's Hospital of Xuzhou from January 2013 to February 2015 were divided into two groups. 34 cases of the combination therapy group, and 31 cases of the pure chemotherapy group. All the patients were subjected to hysterectomia and pelvis lymphadenectomy 2-3 weeks after chemotherapy. The effects, security and merit of the gene therapy in neoadjuvant chemotherapy on cervical cancer were assessed ac-cording to the comparison of the volume of carcinoma before and after operation, the side effects of chemotherapy and the pathology after operation. Results The total effective rate of the combination therapy group was 97.0%, the pure chemotherapy group 83.8%. The total effective rate of the combination therapy group was significantly higher than that of the pure chemotherapy group (P< 0.05). However, the incidence of lymph node metastasis had no statistically sig-nificant difference between the two groups (P> 0.05). The incidence of lymph-vascular space invasion, parametrical infiltration and down muscular invasion in combination therapy group was significantly lower than those of the pure chemotherapy group (P< 0.05). Conclusion The rAd-P53-TP combination has better effect than the TP intravenous chemotherapy in neoadjuvant chemotherapy before the operation of early-stage bulky cervical carcinoma.%目的：比较重组人P53腺病毒注射液联合TP（紫杉醇+顺铂）方案与TP方案在Ib2~Ⅱa期巨块型宫颈癌术前治疗中的效果观察。方法选择2013年1月~2015年2月徐州市第一人民医院收治的巨块型宫颈癌患者65例（FIGO分期Ib2~Ⅱa期），将术前采用重组人P53腺病毒注射液宫颈注射联合TP方案静脉化疗的34例患者作为联合治疗组，术前采用TP方案静脉化疗的31例患者作为单纯化疗组。两组在化疗结束2~3周后行广泛全子宫+盆腔淋巴结切除术。通过比较化疗前后宫颈局部肿瘤病灶的体积变化、化疗毒副作用、术后病理反应等评价基因治疗在宫颈癌新辅助化疗中的作用、安全性及优势。结果联合治疗组总有效率为97.0%，单纯化疗组患者总有效率为83.8%，联合治疗组总有效率高于单纯化疗组，差异有统计学意义（P<0.05）；两组淋巴结转移率比较差异无统计学意义（P>0.05）；联合治疗组脉管浸润、宫旁浸润率及深肌层浸润发生率均低于单纯化疗组，差异均有统计学意义（P<0.05）。结论在早期巨块型宫颈癌术前新辅助化疗中，重组人P53腺病毒注射液宫颈注射联合TP方案静脉化疗较单纯TP方案静脉化疗近期疗效显著。