新辅助化疗结合手术治疗晚期宫颈癌41例临床疗效观察

目的：评价新辅助化疗结合广泛全子宫切除治疗晚期宫颈癌（FIGOⅡb-Ⅳ期）的临床疗效。方法：选取2000年6月-2004年6月在我院确诊的原发宫颈癌（FIGOⅡb-Ⅳ期）患者41例,新辅助化疗方案为卡铂400mg/m^2、丝裂霉素10mg/m^2、长春新碱1mg/m^2,经髂内动脉、子宫动脉灌注化疗＋栓塞1个疗程,经阴道超声测量肿瘤体积。化疗后3周来院评估化疗效果,其中的40例成功实施广泛全子宫切除术加盆腔淋巴结清扫术。结果：新辅助化疗后有效率32/41,有效率为78.0%;9例病变稳定（SD）或进展（PD）。与化疗前相比肿瘤体积显著缩小（P=0.035）。除一例因肺转移放弃手术外均成功实施了宫颈癌根治术、盆腔淋巴结清扫术。主要毒副作用为恶心、呕吐、白细胞减低。结论：新辅助化疗结合手术治疗晚期宫颈癌（FIGOⅡb-Ⅳ期）是安全可行的。MVC方案新辅助化疗可以显著缩小肿瘤体积,降低临床分期,为以往没有手术机会的晚期肿瘤患者提供了手术机会,改善了生存质量。

Efficacy of novel adjuvant chemotherapy in combination with radical hysterectomy for 41 patients with advanced cervical neoplasm

Objective： To evaluate the clinical efficacy of novel adjuvant chemotherapy in combination with radical hysterectomy for advanced cervical carcinoma （ stage higher than FIGO Ⅱ b）. Methods ： Forty-one patients with cervical carcinoma （ stage higher than FIGO Ⅱ b） diagnosed between June 2000-June 2004 were included in this study. The patients received pelvic intra-arterial chemotherapy with carboplatin （400mg/m^2） , vincristine （ 1mg/m^2 ）, and mitomycin （ 10mg/m^2 ）. The tumor volume was measured by transvaginal uhrasonography. Efficacy of the novel adjuvant chemotherapy was evaluated 3 weeks later, and 40 patients underwent radical hysterectomy and pelvic lymphadenectomy. Results： The clinical response rate was 78.0% （32/41）. The disease was stable or progressed in 9 patients. The tumor volume decreased significantly after chemotherapy （ P = 0. 035 ）. Forty patients successfully underwent radical hysterectomy and pelvic lymphadenectomy except for 1 patient due to lung metastasis. The main symptoms were nausea, vomiting and leukopenia. Conclusion： The novel adjuvant chemotherapy for advanced cercivcal carcinoma is safe and feasible. The novel adjuvant chemotherapy with carboplatin, vincristine, and mitomycin can effectively reduce tumor volume, clinical stage, and provide the possibility of operation for the advanced cancer patients who were previously considered un-operable, thus improving their quality of life.