术前放化疗对局部晚期宫颈癌近期疗效分析

摘要

Objective To compare the short-term effect between preoperative chemotherapy and concurrent chemoradiotherapy towards locally advanced cervical cancer.Methods This study retrospectively analyzed the clinical data of 45 patients who were diagnosed with Ib2-Ⅱb cervical cancer and went through preoperative comprehensive therapy.Among these patients,25 of them went through neoadjuvant chemotherapy(NACT)and 20 of them went through concurrent chemotherapy and radiotherapy(CCRT).The short-term effect,intraoperative bleeding loss,the duration of operation and postoperative pathological feature were assessed between NACT group and CCRT group.Results The effective rates of NACT group and CCRT group were 62.86%(23/25)and 100%(20/20)respectively.The proportion of patients who could receive operation was 60%(15/25)in NACT group and 90.00%(18/20).The difference between the two groups was statistically significant(P<0.05).The differences of intraoperative bleeding loss and the duration of operation had no statistical significance(P>0.05).The rate of parametrial infiltration and the rate of lymph node metastasis of CCRT group were lower than those of NACT group.The difference was statistically significant.Conclusion Patients,who suffered from locally advanced cervical cancer and went through 46GY concurrent chemotherapy and radiotherapy 3-4 weeks before operation,would tolerant adverse effect and had better short-term effect than NACT group.%目的 探讨术前化疗和同步放化疗对局部晚期宫颈癌的近期疗效.方法 回顾性分析了45例行术前综合治疗的Ib2-Ⅱb 期宫颈癌患者的临床资料,其中 25 例行术前新辅助化疗(neoadjuvant chemotherapy NACT)、20例行术前同步放化疗(concurrent chemotherapy and radiotherapy,CCRT).评价 NACT 组、CCRT组患者的近期疗效,并比较两组患者术中出血量、手术时间及术后病理特征.结果 NACT 组有效率为 62.86%(23/25),能手术者60%(15/25),CCRT 组为有效率为100%(20/20)能手术者为90.00%(18/20).差异有统计学意义(P<0.05).两组患者手术时间、术中出血量、差异无统计学意义(P>0.05),CCRT 组宫旁浸润率及淋巴结转移率低于NACT组,差异有统计学意义(P<0.05).结论 局部晚期宫颈癌患者术前常规分割同步放化疗 46GY,休息3~4周后手术,不良反应可以耐受,且较术前化疗有更好的近期疗效.