PVM新辅助化疗方案用于局部晚期宫颈癌治疗

目的:探讨PVM新辅助化疗(NACT)方案治疗局部晚期宫颈癌的近期疗效及其对预后的影响。方法:分析46例局部晚期宫颈癌患者行PVM方案新辅助化疗的近期疗效,影响疗效的因素以及术后生存情况。选取23例宫颈癌活检和术后标本进行Ki67和Bax测定。结果:临床总有效率为82.61%,其中2例完全缓解,36例部分缓解,8例稳定。化疗近期疗效与肿瘤体积显著相关(P<0.05)。化疗有效组和无效组患者的平均无瘤生存期为48.9个月和13.7个月(P<0.05)。化疗有反应者NACT后Ki67表达显著降低,Bax表达显著升高(P<0.05);无反应者NACT前后Ki67、Bax表达无统计学差异(P>0.05)。NACT前Ki67着色指数大于33%和小于33%的患者平均无瘤生存期分别为48.6个月和19个月(P<0.05)。结论:PVM方案总体有效率高,使原来无法手术的患者有可能获得手术机会。Ki67、Bax与化疗疗效显著相关,化疗近期疗效仅与肿瘤体积有关。

The Application of PVM Regime on Locally Advanced Cervical Carcinoma

Objective:To investigate the effect of neoadjuvant chemotherapy on locally advanced cervical cancer with PVM regime and its effect on prognosis.Methods:The clinical effect,affecting factors and long-term survival in 46 patients with locally advanced cervical cancer who were treated with neoadjuvant intraarterial chemotherapy were analyzed retrospectively.Expression of Ki67 and Bax protein were evaluated in tumor samples by immunohistochemistry before and after NACT in 23 patients.Results:Overall clinical response were noted in thirty-eight patients(82.61%)including two complete response and thirty-six partial response.The effective rate was associated with tumor volume(P<0.05).The mean disease-free survival of patients who responded to chemotherapy was significantly longer than that of those who did not respond(48.9months vs.13.7 months,P<0.05).The expression of Ki67 was significantly lower for responders than for non-responders after chemotherapy,while Bax was significantly higher for responders than for non-responders.The mean disease-free survival of patients with Ki67 LI>33% before chemotherapy was significantly longer than that of patients with Ki67 LI<33%(48.6 months vs.19 months,P<0.05).Conclusion:PVM regime can yield a high response rate with acceptable toxicity,which make radical surgery feasible in cases previously considered imoperable.Clinical effect of NACT may be related with Ki67 and Bax protein.The effective rate is associated with tumor volume.