Clinical Research of Neoadjuvant Chemotherapy in Cervical Cancer
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摘要: 目的 探讨宫颈癌新辅助化疗的临床疗效。方法回顾性分析我院2001年1月—2005年11月采用新辅助化疗(NACT)+手术+放疗的44例ⅠB2期~ⅡB期宫颈癌患者的临床资料（治疗组），并选择同期52例ⅠB2期~ⅡB期行手术+放疗的患者（对照组）做对比研究。结果44例行NACT患者中，CR 6例(13.64%)，PR 21例(47.73%);SD 13例(29.55%)，PD 4例(9.09%)，总有效率为61.36%(27/44)；不良反应主要为骨髓抑制、胃肠道毒性、脱发等，均可耐受，未影响手术治疗。96例术后全部作病理检查，治疗组2例(4.55%)切缘阳性，7例(15.91%)盆腔淋巴结阳性；对照组14例(26.92%)切缘阳性，20例(38.46%)盆腔淋巴结阳性，两项指标两组率的比较差异均有统计学意义（P<0.05）。全部96例患者均获得随访，治疗组44例患者中，41例(93.18%)存活3年，38例(86.36%)存活5年；对照组52例患者，45例(86.54%)存活3年，35例(67.31%)存活5年，两组5年生存率差异有统计学意义（P<0.05）。结论术前新辅助化疗可提高ⅠB2 期~ⅡB期宫颈癌的近期疗效,为根治性手术创造条件,且NACT+手术+放疗可提高患者5年生存率。Abstract: Objective To explore the curative effect of neoadjuvant chemotherapy for stage ⅠB2~ⅡB cervical cancer. Methods Forty-four cases of stage ⅠB2~ⅡB cervical cancer treated by neoadjuvant chemotherapy(NACT) + surgery + radiotherapy,and 52 cases of stage ⅠB2~ⅡB treated by surgery + radiotherapy from January 2001 to November 2005 were retrospectively analyzed. Results In 44 patients of NACT,CR,PR,SD and PD were 6 cases (13.64%),21 cases (47.73%),13 cases (29.55%) and 4 cases (9.09%),respectively.Total effective rate was 61.36% (27/44).Toxicities including bone marrow suppression,gastrointestinal toxicity and hair loss,were tolerable and did not effect the surgery.All 96 cases were pathologically examined after surgery.In the treatment group，the prevalence rates of positive margins and positive pelvic lymph nodes were 2 (4.55%) and 7 patients (15.91%) and lower than those in the control group 14 cases (26.92%) and 20 patients (38.46%),respectively,P<0.05).In the treatment group,3 years and 5 year survival time were 93.18% (41/44) and 86.36% (38/44) and increased than those in the control group( 86.54% and 67.31%,P<0.05). Conclusion Neoadjuvant chemotherapy could improve the prognosis of stage ⅠB2~ⅡB cervical cancer.
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Key words:
- Cervical neoplasms /
- Neoadjuvant chemotherapy /
- Surgery
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[1] Sardi JE,Boixadera MA,Sardi JJ.Neoadjuvant chemotherapy in cervical cancer new trend[J].Curt OpinObstet Gynecol,2005,17(1):43-7. [2] Orsini LF，Salardi S，Pilu G，et al.Pelvic organs in premenarcheal girls:real-timeultrasonography[J].Radiology，1984,153(1):113-6. [3] Xie CM,Pang ND,Yang ML,et al.To evaluate contributions of interventional therapy for radicalhysterectomy of advanced cervical carcinoma[J].Zhongguo Jie Ru Ying Xiang Yu Zhi Liao Xue,2008,5(1):5-8.[谢春明,庞宁东,杨敏玲,等.介入治疗对中晚期宫颈癌手术切除的影响[J].中国介入影像与治疗学,2008,5(1):5-8.] [4] Duan YC,Hu P.Advances in the treatment of cervical cancer[J].Guo Wai Yi Xue:Fu Chan Ke XueFen Ce，2007,34(2):137-9.[段迎春,胡平.宫颈癌的治疗进展[J].国外医学:妇产科学分册,2007,34(2):137-9.] [5] Benedetti Panici P，Bellati F，Pastore M，et al.An update in neoadjuvant chemotherapy incervical cancer[J].Gynecol Oncol，2007，107（1 Suppl 1）：S20-2. [6] Nguyen HN，Nordqvist SR.Chemothpy of advanced and recurrent cervical carcinoma[J].Semin SurgOncol,1999,16(3):247-50. [7] Liu JH,Xiong Y.Evaluation of clinical value of neoadjuvant chemotherapy in the treatment ofcervical neoplasms[J].Zhongguo Fu Chan Ke Lin Chuang Za Zhi,2008,9(3):163-165.[刘继红,熊樱.对宫颈癌新辅助化疗临床价值的评价[J].中国妇产科临床杂志,2008,9(3):163-5.] [8] Cai HB,Chen HZ,Yin HH.Randomized study of preoperative chemotherapy versus primary surgery forstage IB cervical cancer[J].J Obstet Gynaecol Res,2006,32(3):315-23. [9] Yamakawa Y,Fujimura M,Hidaka T,et al.Neoadjuvant intraarterial infusion chemotherapy inpatients with stage IB2-IIIB cervical cancer[J].Gynecol Oncol,2000,77(2):264-70. [10] Terai Y,Kanemura M,Sasaki H,et al.Long-term follow-up of neoadjuvant intraartefialchemotherapy using an original four-lumendouble-balloon (4L-DB)catheter for locally advanced uterinecervical carIcer[J].Int J Clin Oncol,2009,14(1):56-62.
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