目的：探讨不同新辅助化疗（NACT）治疗局部晚期宫颈癌患者的疗效和安全性。方法：选取2010年1月-2013年4月在我院择期接受根治术治疗的Ⅰb2~Ⅱb 期局部晚期宫颈癌患者99例，其中69例患者术前接受 NACT （化疗组），30例患者术前未接受辅助治疗（对照组），并根据术前化疗途径将化疗组患者分为动脉组（动脉介入栓塞化疗，n=37）和静脉组（全身静脉化疗，n=32），观察化疗组患者近期疗效和毒副反应发生情况，比较3组患者术后病理结果，并采用 Kaplan-Meier 法计算3组患者术后1、2年生存情况。结果：动脉组和静脉组近期临床疗效的总有效率分别为78.38%和75.00%（P ＞0.05）；动脉组 II 级骨髓抑制发生率明显低于静脉组（P ＜0.05），淋巴结转移发生率明显高于静脉组（P ＜0.05）；化疗组脉管癌栓和淋巴结转移发生率均明显低于对照组（P ＜0.05），术后生存情况均明显优于对照组（P ＜0.05），静脉组术后生存情况明显优于动脉组（P ＜0.05）。结论：术前 NACT 可明显改善患者术后生存情况，全身静脉化疗较动脉介入栓塞化疗更具优势。%Objective: To discuss the efficacy and safety of different neoadjuvant chemotherapies (NACT) in the treatment of cervical cancer. Methods: Ninety-nine cases of patients with stage Ib2~IIb locally advanced cervical cancer in our hospital from January, 2010 to April, 2013 were divided into a chemotherapy group (with NACT, n=69) and a control group (without NACT, n=30). The chemotherapy group were further divided into an artery subgroup (artery interventional embolization chemotherapy, n=37) and a vein subgroup (intravenous chemotherapy, n=32) based on the ways of preoperative chemotherapy. The recent efficacy and the incidence of adverse drug reaction in the chemotherapy group were compared. The postoperative pathological results were compared and 1~2 year survival after operation was calculated by Kaplan-Meier method between two groups. Results: The total efficiency was 78.38% in the artery subgroup and 75.00% in the vein subgroup (P>0.05). The incidence of class II bone marrow suppression was significantly lower in the artery subgroup than in the vein subgroup (P<0.05) while the incidence of lymph node metastasis was significantly higher in the artery subgroup than in the vein subgroup (P<0.05). The incidence of cancer embolus and lymph node metastasis was significantly lower in the chemotherapy group than in the control group (P<0.05). The postoperative survival was significantly better in the chemotherapy group than in the control group (P<0.05) while it was much better in the vein subgroup than in the artery subgroup (P<0.05). Conclusion: The survival situation of patients with locally advanced cervical cancer can be obviously improved by NACT before operation and the intravenous chemotherapy has more advantages compared with artery interventional embolization chemotherapy.
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