经动脉新辅助化疗在宫颈癌治疗中的疗效分析

摘要

Objective To explore the clinical value of neoadjuvant intra-arterial chemotherapy (NAIT) in the treatment of cervical cancer. Methods 87 patients with cervical cancer between I b2 to FJ b stage were randomly divided into observation group (44 cases) and control group (43 cases). The observation group was given arterial NAIT for 1 to 2 courses, underwent radical surgery. The control group was directly radical surgery without receiving NAIT before surgery. The tumor size of the observation group were compared before and after treatment and the NAIT adverse reactions were recorded. The clinical efficacy including surgery time, blood lossi pathological features were observed. Results There were 4 cases with CR and 22 cases with PR. The efficiency was 70. 5%. The deflation in tumor size of observation group was very obvious after treatment. The operative time and blood loss of observation group were fewer than that of control group (P<0. 05). The lymph node metastasis of observation group and control group were 16. 09% and 29. 58% (P<0. 05). The deep myometrial invasion of observation group and control group were 53. 62% and 67. 61% of cervical cancer (P>0. 05). The parametrial invasion of observation group and control group were 2.90% and 1.41% (P> 0. 05). Conclusion NAIT preoperative cervical cancer can reduced tumor size, shorter operative time, less blood loss, reduce the rate of lymph node metastasis and improve efficacy.%目的 探讨新辅助化疗(NAIT)在宫颈癌治疗中的临床价值.方法 对87例I b2～Ⅱb期宫颈癌患者按入院先后随机分为观察组44例与对照组43例,观察组予1～2个疗程经动脉NAIT后,行根治性手术;对照组术前未接受NAIT,直接行根治性手术.比较观察组治疗前后肿瘤大小的变化,记录NAIT的不良反应;比较两组的手术时间、术中出血量、术后病理特征.结果 观察组患者中CR 4例,PR 22例,有效率70.5％;观察组的手术时间明显短于对照组,术中失血量少于对照组(P＜0.05).术后两组标本病理检查比较:淋巴结转移分别为16.09％和29.58％,差异有显著性(P＜0.05)；而宫颈肿瘤的深肌层浸润分别为53.62％和67.61％,宫旁浸润分别为2.90％和1.41％,差异均无显著性(P＞0.05).结论 宫颈癌术前行NAIT可缩小肿瘤大小,缩短手术时间,减少术中出血量,降低淋巴结转移率,提高疗效,值得推广.