新辅助化疗在宫颈癌治疗中的疗效分析

目的:探讨新辅助化疗在宫颈癌临床治疗中的作用。方法:以170 例宫颈癌病例（Ⅰb～Ⅳ期）为新辅助化疗试验组，同期同条件未经新辅助化疗的160 例病例为对照组进行回顾性分析。按其治疗方法将研究病例分为6 组，两两配对:NS组（新辅助化疗+ 手术）与S 组（单纯手术）；NSR 组（新辅助化疗+ 手术+ 放疗）与SR组（单纯手术+ 放疗）；NR组（新辅助化疗+ 放疗）与R 组（单纯放疗）；进行配对组间比较。结果:新辅助化疗的总有效率为70% 。NS组的1、3 及5 年生存率分别为87% 、81% 和81% ；对照S 组的为97% 、93% 和93%（P 均>0.05）；两组生存曲线无显著性差异（P=0.685）。 NSR 组的1、3 及5 年生存率分别为100% 、93% 和93% ；对照SR组的为100% 、100% 和92%（P 均>0.05）；两组生存曲线无显著性差异（P=0.351）。 NR组的1、3 及5 年生存率分别为76% 、45% 和36% ；对照R 组的为81% 、54% 和37%（P 均>0.05）；两组生存曲线无显著性差异（P=0.723）。 各组新辅助化疗的不良反应以胃肠道反应为主，患者均可耐受。结论:在宫颈癌治疗中，新辅助化疗虽然不能显著提高宫颈癌患者的生存率，但仍是一种安全的、有较好近期疗效的治疗方法。 

Effect of Neoadjuvant Chemotherapy on Cervical Cancer

Objective:To evaluate the efficacy and toxicity of neoadjuvant chemotherapy for cervical cancer. Methods: From 1985 to 2006, 330 patients with stage Ib-IV cervical cancers were managed into six groups (three pairs). Pair one: NS (NACT followed by surgery) compared with S (Surgery alone); Pair two: NSR (NACT followed by surgery and adjuvant radiotherapy) compared with SR (Surgery followed by adjuvant radiotherapy); Pair three: NR (NACT followed by radical ra -diotherapy) compared to R (Radical radiotherapy alone). Results: Overall effective rate of NACT was70%. Pair one: The pa-tient survival rates at 1, 3, and 5 years were 87% ,81% , and81% (NS) versus 97% ,93% and 93% (S), respectively ( P > 0.05). Pair two: The patient survival rates at 1, 3, and 5 years were 100 %,93%, and93% (NSR) versus100 %,100 % and 92% (SR), respectively (P > 0.05). Pair three: The patient survival rates at 1, 3, and 5 years were 76%,45%, and36% (NR) versus 81% ,54% and 34% (R), respectively (P > 0.05). No significant differences were found in survival curves among these three pairs. The most common adverse reactions were gastrointestinal reactions. Conclusion:NACT is effective for cervical cancer but with no benefit for overall survival.