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新辅助化疗与术前放疗治疗宫颈癌的临床疗效对比观察 |
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p was 83.1% with stage Ⅰb 81.5% and stage Ⅱa 84.2%,and effective rate of radiotherapy group was 88.5% with stage Ⅰb 87.1% and Ⅱa 89.4%.There was no significant difference (P>0.05)。Preoperative efficacy of different type of pathology:the effective rate of patients with poorly differentiated squamous cell carcinoma in NACT group was 91.7% and in radiotherapy group was 94.5%;While moderatehighly differentiated ones in NACT group was 63.6% and in radiotherapy group was 87.5%.There was no significant difference between the two groups (P>0.05).Preoperative adverse reactions were as follows:gastrointestinal reaction rate in NACT group was 27.7% of grade Ⅰ,20.0% of grade Ⅱ and 1.54% of grade Ⅲ，and the rate of the decrease of white blood cell and platelet was 4.62% of grade Ⅰ,while there was not adverse reaction occured.Recurrent rate and life span:7.9% was 2year recurrent rate in NACT group and 18.7% in radiotherapy group,while 12.7% was 3year recurrent rate in NACT group and 29.3% in radiotherapy group.There was significant difference between the two groups (P<0.05).2,3year survival rate of NACT group and radiotherapy group was 95.2%,87.3% and 89.3%,85.3% respectively (P>0.05).Conclusion 2,3recurrent rate of patients treated by NACT are significantly lower than those treated by radiotherapy with the same efficacy and safety.In addition,NACT is economical and simply which is worth of wide use.
【Key words】 cervix neoplasms;chemotherapy, adjuvant;infusion,intravein;radiotherapy
宫颈癌是妇科常见的恶性肿瘤之一。近年来，巨块型(肿瘤直径≥4cm)及局部晚期宫颈癌的发病率呈明显上升趋势，且发病年龄趋向年轻化[1]。临床上，巨块型宫颈癌颇多见，其转移的发生率高，手术切除难度较大，是巨块型宫颈癌治疗失败的原因之一。常规治疗手段是术前先行放疗，以缩小肿瘤，提高完全切除的可能性，降低癌细胞活性及术中播散。新辅助化疗(NACT)的临床运用及发展，为综合治疗巨块型宫颈癌开辟了一条新的途径。本研究对65例巨块型宫颈癌患者术前采用全身静脉给药的新辅助化疗，与78例术前进行腔内后装治疗的巨块型宫颈癌患者的临床放疗进行比较，探讨新辅助化疗在宫颈癌综合治疗中的价值。
1 资料与方法
1.1 一般资料 病例选自1998年3月～2004年2月期间入院的原发性Ⅰb～Ⅱa期巨块型宫颈癌患者143例，术前全部经妇科检查及病理确诊，且随访等资料均完整。患者年龄22～68岁，中位年龄41.4岁;临床分期[按国际妇产科联盟(FIGO)临床分期标准，1995年制定，2003年修订]：Ⅰb期58例，Ⅱa期85例;病理类型：低 上一页 [1] [2] [3] [4] [5] 下一页
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