三种宫颈癌新辅助化疗方案的疗效及化疗毒副反应比较研究

目的通过比较三种新辅助化疗方案在治疗宫颈癌方面的疗效及并发的毒副反应,并进行综合评价,总结出最佳新辅助化疗方案。方法回顾分析我院2008年3月至2011年12月98例放疗前或术前行新辅助化疗的宫颈癌患者,按所接受的化疗方案类别随机分为三组,其中采用顺铂＋异环磷酰胺＋博莱霉素顺（PIB）组为26例;顺铂＋长春新碱＋博来霉素＋丝裂霉素（PVBM）组为31例;顺铂＋5-氟尿嘧啶（PF）组为41例。所有患者均于化疗结束后15~20天,行宫颈癌根治术。结果 PIB组有效率达88.46%,PVBM组有效率达87.09%,PF组有效率达85.36%,新辅助化疗方案总有效率达86.73%,三组疗效差异对比,无统计学意义（P〉0.05）。而化疗毒副反应发生率较其它两组低,差异对比,有统计学意义（P〈0.05）。结论宫颈癌新辅助化疗能够有效控制宫颈病灶,为手术及放疗提供较好的准备,经综合分析,顺铂＋5-氟尿嘧啶方案相对副作用较少,可作为首选的辅助化疗方案。

Comparative Study on the Therapeutic Effect and Toxicity of Three Kinds of New Adjuvant Chemotherapy Treatment for Cervical Cancer

Objective To compare the therapeutic effect and toxicity of three kinds of new adjuvant chemotherapy treatment （NACT） for cervical cancer, and summarize the best neoadjuvant chemotherapy. Methods 98 cervical cancer patients with new adjuvant chemotherapy treatment before radiotherapy or operation in our hospital from March 2008 to December 2011 were analyzed retrospectively and randomly divided into 3 groups： 26 cases of PIB group （cisplatin ＋ ifosfamide ＋ bleomycin）, 31 cases of PVBM group （cisplatin ＋ vincristine ＋ bleomycin ＋ mitomycin） and 41 cases of PF group （cisplatin ＋ 5-fluorouracil）. All patients received the radical hysterectomy of cervical cancer 15 ~ 20 days. Results The effective rate of the PIB group was 88.46%, the effective rate of the PVBM group was 87.09%, the effective rate of the PF group was 85.36%, the total effective rate of new adjuvant chemotherapy treatment was 86.73%; the differences of effective rates among the three groups were not statistically significant （P 0.05）. The chemotherapy toxicity incidence in PF group was lower than that in PIB group and PVBM group and the differences between PF group and the other two groups were statistically significant respectively （P 0.05）. Conclusions New adjuvant chemotherapy treatment （NACT） for cervical cancer can effectively control the cervical lesions and provide better preparation for surgery and radiotherapy. Cisplatin plus 5-fluorouracil has fewer side effects, which can be used as the preferred adjuvant chemotherapy.