新辅助化疗治疗宫颈癌43例临床分析

目的探讨新辅助化疗在Ib～1Ib期宫颈癌辅助治疗中的临床效果。方法43例宫颈癌患者术前采用2个疗程的静脉化疗，化疗结束后2-3周全部行宫颈癌根治术。通过观察患者的化疗毒副反应、术中情况、术后病理反应及术中术后并发症，评价新辅助化疗在宫颈癌治疗中的作用。结果43例术后病理阴道切缘及宫旁切缘均无癌残留。术前化疗组与直接手术组比较，术前化疗组较直接手术组的病理情况（淋巴结阳性，宫旁累及阴道切缘阳性）差异有统计学意义（P〈0．05），术前化疗组较直接手术组的术中出血量、术中血管、膀胱、输尿管损伤及术后下肢水肿差异有统计学意义（P〈0．05），而术前化疗组与直接手术组手术时间、术中术后并发症（尿潴留、淋巴囊肿、便秘以及膀胱麻痹）方面的差异均无统计学意义。结论宫颈癌术前新辅助化疗并不增加手术时间、术中出血量及术后并发症，是比较安全有效的治疗方法，应用于临床对病灶缩小、术中减少出血、提高手术切净率效果显著。

Neoadjuvant Chemotherapy of Cervical Cancer

Objective To evaluate the efficacy of neoadjuvant chemotherapy in the treatment of cervical cancer, stage Ib-1Ib. Methods Two courses of intravenous chemotherapy was applied to 43 patients with cervical cancer. Radical hysterectomy was performed at 2-3 weeks after chemotherapy. The efficacy was evaluated through the observation of the side effects,intraoperative conditions and postoperative pathological reactions. Results Pathological examination indicated that there was no residual tumour along the cutting edge of vagina and the uterus.The pathological conditions （lymph node-positive, beside of uters involving the vaginal surgical margin positive）of patients in the preoperative chemotherapy group was significantly （P〈0.05） different from the direct operation group. Blood loss,intraoperative blood vessels,bladder,ureter injury and postoperative lower limb edema in the preoperative chemotherapy group was also significantly （P〈0.05） different from the direct operation group.The operation time, intraoperative and postoperative complications （urinary retention, lymphatic cyst, constipation, and urinary bladder paralysis ）were not significantly different between the preoperative chemotherapy group and the direct operation group. Conclusion Neoadjuvant chemotherapy before surgery would not increase the operation time,blood loss and postoperative complications in patients with cervical cancer. This method is relatively safe and effective.