紫杉醇脂质体联合卡铂在局部晚期宫颈癌新辅助化疗中的应用

【目的】评价紫杉醇脂质体（力扑素）联合卡铂（TP）在局部晚期宫颈癌患者治疗中的作用。【方法】选择2006年12月-2007年12月经病理确诊9例局部晚期宫颈癌患者为观察对象，采用力扑素静滴联合卡铂动脉栓塞方案行新辅助化疗，于1疗程化疗后3周来院复诊，根据检查决定进入第2疗程化疗或行手术或放疗。【结果】介入治疗后，完全缓解（CR）：4例（4／9），部分缓解（PR）：4例（4／9）；其中8例手术，6例行1疗程化疗结束后手术，2例行2疗程化疗后手术，此2例因行BOMP方案介入治疗1疗程后宫旁条件改善不理想而行TP方案1疗程，1例2疗程后放疗。8例手术患者术中出血明显减少，术后病检均未发现有宫旁浸润，阴道切缘均阴性，仅1例淋巴结转移。【结论】力扑素静滴联合卡铂动脉栓塞方案化疗治疗局部晚期宫颈癌，反应率高，手术切除率高，术中出血减少，近期疗效显著。

Application of neoadjunvant chemotherapy with paclitaxel liposome for injection and carboplatin in locally advanced cervical cancer

[Objective] To evaluate the curative effect of a neoadjuvant chemotherapy with TP （paclitaxel liposome for injection and carboplatin） locally in advanced cervical. [Methods] The clinical data of 9 patients with locally advanced cervical cancer treated by a neoadjunvant interventional chemotherapy with TP were analyzed. The neoadjuvant intraarterial infusion chemotherapy and superselective embolization of the arterial blood of the cancer were performed. The patients were return visit in the third weeks after one course of chemotherapy was finished. One course chemotherapy was followed by either second course chemotherapy or operation or radiotherapy according to the patients conditons. [Results] 4 patients （4/9） showed complete remission after chemotherapy, 4 cases （4/9） showed partial remission. Of 8 patients with cervical cancers, 6 were underwent surgery after one course of chemotherapy , 2 after two courses of chemotherapy which including the cases with BOMP in the first course of chemotherapy. The parametrial involvement and positive vaginal resection margins were not found in 8 undergoing surgical treatment with less bleeding. Pelvic lymph node metastasis was found in 1 patient only. [Conclusions] Preoperative neoadjuvant interventional chemotherapy with TP is an effective methods to locally advanced cervical cancer, which can decrease the primary tumor effectively and increase surgical rates with less bleeding. The curative effect of TP chemotherapy in the near future were relatively significant.