介入栓塞化疗与新辅助静脉化疗联合调强放疗治疗晚期宫颈癌的疗效比较

摘要

目的：比较介入栓塞化疗与新辅助静脉化疗联合调强放疗治疗晚期宫颈癌疗效。方法宫颈癌患者65例，按随机数字表法分为介入栓塞化疗联合调强放疗32例（介入栓塞组），新辅助静脉化疗联合调强放疗33例（新辅助化疗组）。观察两组患者近期有效率、获益率、治疗前后肿瘤直径变化及不良反应的差异。结果介入栓塞组近期疗效好于新辅助化疗组（P＜0．05），其中介入栓塞组总有效率（53．1％）高于新辅助化疗组（27．3％）（P＜0．05），但两组临床获益率差异无统计学意义（90．6％比84．8％，P＞0．05）。治疗后两组肿块均明显缩小（P＜0．001），且介入栓塞组肿块直径[（2．8±0．3）cm]小于新辅助化疗组[（3．5±0．4）cm]（P＜0．01）。介入栓塞组盆腔疼痛发生率（87．5％）高于新辅助化疗组（12．1％），骨髓抑制发生率（9．4％）低于新辅助化疗组（33．3％）（P＜0．05）。结论介入栓塞化疗与新辅助静脉化疗联合调强放疗对晚期宫颈癌均有较好的近期疗效，但介入栓塞化疗联合调强放疗疗效更好。%Objective To compare the therapeutic effects of interventional chemoembolization versus neo-adjuvant vein chemotherapy combined with intensity-modulated radiation therapy(IMRT) for advanced cervical carcinoma.Methods Sixty-five patients with cervical carcinoma were randomly divided into chemoembolization group and neo-adjuvant chemotherapy group.Thirty-two cases in the chemoembolization group accepted interventional chemoembolization combined with IMRT.Thirty-three cases in the neo-adjuvant chemotherapy group accepted neo-adjuvant vein chemotherapy combined with IMRT.The short-term effective rate,probability rate,tumor diameter changes before and after treatment,and side-effects after treatment were observed in two groups.Results Chemoembolization group achieved better efficancy compared with neo-adjuvant chemotherapy group(P<0.05).The overall effective rate of chemoembolization group was higher than that of neo-adjuvant chemotherapy group(53.1%vs.27.3%,P<0.05).There was no significant difference in the probability rate between two groups(90.6%vs.84.8%,P>0.05).After treatment,the tumor sizes reduced significantly in two groups(P<0.05),and the tumor diameter of chemoembolization group was significantly smaller than that of neo-adjuvant chemotherapy group((2.8 ±0.3)cm vs.(3.5 ±0.4)cm, P<0.01).Chemoembolization group obtained a higher incidence of pelvic pain and a lower incidence of bone marrow depression compared with neo-adjuvant chemotherapy group(87.5%vs.12.1%,9.4%vs.33.3%,respectively,P<0.05).Conclusion Both interventional chemoembolization versus neo-adjuvant vein chemotherapy combined with IMRT have better short-term effects on advanced cervical carcinoma. But interventional chemoembolization combined IMRT achieves a superior efficacy.