摘要：
Objective To investigate the clinical efficacy of pemetrexed combined with oxaliplatin in neoadjuvant chemotherapy in cervical squamous cell carcinoma. Methods Sixty patients with cervical squamous cell carcinoma who were diagnosed and treated in our hospital from January 2014 to January 2015 were selected as the subjects, randomly divided into two groups, each group of 30 cases, the patients in the control group were treated with surgery alone, and the patients in the study group were treated with neoadjuvant chemotherapy with pemetrexed combined with oxaliplatin for 2 ～ 3 weeks. To compare the clinical efficacy of the two groups of patients and the safety of neoadjuvant chemotherapy, at the same time, all patients were followed up for two years, and their lymph node metastasis rate, local recurrence rate and survival rate were statistically analyzed. Results After neoadjuvant chemotherapy, the tumor group was significantly reduced, the tumor size before and after chemotherapy were compared, the difference was statistically significant (P ＜ 0. 05); The results of chemotherapy results showed that the effective rate of Ⅰb2 patients reached 92. 85％, the effective rate of stage Ⅱa was 69. 23％, the effective rate was only 33. 33％, the total effective rate was 76. 67％; The main side effects are digestive and blood systems, but less severe, can be tolerable; There was no significant difference between the two groups in the results of the operation time and the amount of bleeding, but the pathological results showed that compared with the control group, the observation group of patients with vascular invasion, vaginal margin positive rate, uterine accumulation rate and lymph node positive rate were significantly reduced, the difference was statistically significant (P ＜ 0. 05); Long-term results showed that the lymph node metastasis rate and local recurrence rate were significantly lower in the study group compared with the control group, and the survival rate of the patients was significantly increased, and the difference between the two groups was statistically significant (P ＜ 0. 05). Conclusion Neoadjuvant chemotherapy with pemetrexed and oxaliplatin for patients with for squamous cell carcinoma is safe and effective, which reduce the risk of postoperative lymph node metastasis and recurrence, improve patient survival, worthy of clinical promotion.%目的 探讨培美曲塞联合草酸铂的新辅助化疗在宫颈鳞癌治疗中的临床效果.方法 选取宫颈鳞癌患者60例作为研究对象,随机将其分为2组,每组30例.对照组患者直接接受单纯手术治疗;而研究组患者在经过培美曲塞联合草酸铂进行新辅助化疗23周后,再接受手术治疗.比较2组患者的临床疗效以及新辅助化疗的安全性,同时对所有患者进行为期2年的随访,对其淋巴结转移率、局部复发率以及生存率进行统计分析.结果 研究组患者在经过新辅助化疗后,肿瘤显著减小,与化疗前比较,差异具有统计学意义(P ＜0.05);化疗总有效率为76.67％;其中Ⅰb2期患者有效率达到92.85％,Ⅱa期患者有效率达到69.23％,Ⅱb期术前有效率只有33.33％.毒副作用主要是消化和血液系统,但程度较轻,均可耐受.2组患者在手术时间与出血量上比较,差异无统计学意义(P＞ 0.05);但术后的病理结果表明与对照组比较,观察组患者脉管浸润率、阴道切缘阳性率、宫旁累积率以及淋巴结阳性率都显著降低,差异具有统计学意义(P ＜0.05);术后远期疗效结果显示相比于对照组,研究组患者的淋巴结转移率以及局部复发率都明显降低,同时患者的生存率显著提高,且2组之间差异具有统计学意义(P ＜0.05).结论 培美曲塞联合草酸铂的新辅助化疗在宫颈鳞癌的治疗中安全有效,可减少术后淋巴结转移以及复发的几率,提高患者的生存率,值得临床推广.
