首页> 中文期刊> 《医学理论与实践》 >早期巨块型宫颈癌术前放化疗与新辅助化疗的临床观察

早期巨块型宫颈癌术前放化疗与新辅助化疗的临床观察

             

摘要

Objective :To evaluate the efficiency and the recent toxicity of preoperative chemoradiotherapy and neoadju‐vant chemotherapy for the patients with the bulky early‐stage cervical cancer .Methods :75 patients with Ⅰ B2 and Ⅱ A bulky cervical cancer were divided into two groups of A (40 cases ,chemoradiotherapy )and B (35 cases ,neoadjuvant chemotherapy) .A group was treated with two cycles of chemotherapy and concurrent with internal radiotherapy with a dose of 20 ~ 28Gy(5 ~ 7Gy/1 fr /week ,4 fractions) .B group was treated with the same chemothetapy regimen and dos‐age as A group .Both groups then underwent radical hysterectomy in 2 to 4 weeks after theraphy .The efficacy and ad‐verse effects of both groups were studied .Results :The effective rate(CR + PR)of A group and B group were 97 .5% and 71 .4% respectively .Pathologic complete remission of A group and B group were 37 .5% and 11 .4% .There were all significant different ( P < 0 .05) .The side effect of chemoradiotheraphy can be toleranced . There was no statistical difference in the incidence of serious adverse event .Conclusion :The patients treated with chemoradiotherapy have better clinical effect than patients treatd with neoadjuvant chemotherapy .The side effect of chemoradiotherapy can be toler‐anced .%目的:探讨早期巨块型宫颈癌术前同步放化疗与单纯化疗的临床疗效及毒副反应。方法:将75例Ⅰ B2~Ⅱ A期巨块型宫颈癌分为2组,术前放化疗组(A 组)40例和新辅助化疗组(B 组)35例。 A 组放疗采用单纯腔内后装放疗,A 点总剂量为20~28Gy(5~7Gy/次,1次/周,共4次),同期行 TP 方案化疗2个周期;B 组化疗方案剂量与 A 组相同。术前治疗结束后2~4周进行手术,分析两组近期疗效及毒副反应。结果:A 组与 B 组总有效率(CR + PR)分别为97.5%和71.4%(P<0.05),术后病理完全缓解率 A 组37.5%,B 组11.4%(P<0.05),两组总有效率和术后病理完全缓解率差异均有统计学意义。术前放化疗毒副反应均能耐受,Ⅲ~Ⅳ级毒副反应两组比较差异无统计学意义。结论:早期巨块型宫颈癌术前行同步放化疗近期疗效较新辅助化疗好,毒副反应可以耐受。

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