宫颈癌新辅助化疗疗效分析

目的探讨ⅠB2～ⅡB期宫颈癌术前化疗联合手术治疗疗效。方法回顾性分析2005年6月至2009年4月在北京大学人民医院手术治疗的66例ⅠB2～ⅡB期宫颈癌患者的病例资料,根据术前是否行化疗,分为术前化疗组（研究组）和直接手术组（对照组）,评价新辅助化疗组的近期疗效,比较两组的手术时间、术中出血量、盆腔淋巴结转移率、脉管癌栓阳性率、宫旁及阴道断端有无癌转移等。结果 41例宫颈癌患者术前行新辅助化疗的总临床有效率为58.54%（24/41）,完全缓解率为4.87%（2/41）,部分缓解率为53.65%（22/41）,病情稳定36.58%（15/41）,疾病进展4.87%（2/41）。研究组淋巴、脉管癌栓转移率36.58%（15/41）,对照组72.00%（18/25）,研究组低于对照组,差异有统计学意义（P〈0.05）,手术时间、出血量差异无统计学意义（P〉0.05）。结论宫颈癌患者术前行新辅助化疗可有效缩小病灶,降低淋巴、脉管内癌栓转移率。

Analysis of effect of neoadjuvant chemotherapy in the treatment of cervical cancer

Objective To assess the effect of neoadjuvant chemotherapy （NACT） in the treatment of stage Ⅰ B2-Ⅱ B cervical cancer. Methods 66 patients diagnosed with stage Ⅰ B2~Ⅱ B cervical cancer and treated at Peking University People＇s Hospital from June, 2005 to April, 2009 were reviewed. The patients were divided into study group who received NACT prior to surgery （NACT group） and control group who received primary surgery treatment （PST group）. The recent effect of NACT was estimated by analyzing the operation time, the amount of bleeding, the metastasis rate of pelvic lymph nodes, the rate of lymph-vascular space involvement （LVSI）, the metastasis of parametrium and vaginal cuff.Results Of the 66 patients,41 patients received NACT,among them the clinical total effective rate was 58.54%（24/41）,the complete remission rates was 4.87%（2/41）,the partial remission rate was 53.65%（22/41）,15 of which were in stable condition（36.58%） and 2 were in progression（4.87%）. Compared with patients treated by PST, the estimated blood loss, operation time, number of lymph nodes removed and the complication rates during and after surgery in NACT patients had no significant difference. The LVSI rate was 36.58% （15/41） in NACT group, which was significant lower than that in the PST group （72.00%,18/25,P0.05）.Conclusions NACT in the treatment of cervical cancer can effectively reduce tumor volume and reduce the rate of LVSI.