局部晚期宫颈癌患者新辅助化疗疗效观察简

目的 探讨局部晚期宫颈癌患者术前新辅助化疗的疗效.方法 分析55例IB2期宫颈癌经1～2疗程＂伊替立康＋奈达铂＂方案新辅助化疗的患者（实验组）和32例直接行根治性手术的宫颈癌患者（对照组）的临床资料,评价新辅助化疗（NACT）在IB2期宫颈癌治疗中的作用.结果 ＂伊立替康＋奈达铂＂方案化疗不良反应轻,总有效率为89.09%,其中完全缓解（CR）16.36%,部分缓解（PR）72.72%,鳞癌有效率90.0%,腺癌有效率75.0%,新辅助化疗组术后盆腔淋巴结转移为19.0%,明显低于对照组患者（33.8%,P〈0.05）.两组患者宫旁侵润及阴道切缘阳性间差异不具有显著性意义（P〉0.05）,新辅助化疗组3年累积生存率70.12%,明显高于对照组55.26% （P〈0.05）.结论 新辅助化疗治疗局部晚期宫颈癌安全有效,可缩小局部病灶,降低部分患者临床分期,提高手术率,控制盆腔淋巴结转移,并减少化疗并发症或手术并发症的发生.

Observation on patients with advanced local cervical cancer treated with neo-adjuvant chemotherapy

Objective To explore the efficacy of neo - adjuvant chemotherapy in treatment of patients with IB2 advanced local cervical carcinoma. Methods The clinical data of 55 patients with cervical cancer at IB2 stage treated by 1 to 2 courses of ＂ irinotecan plus nedaplatin＂ neo - adjuvant chemotherapy and 32 patients with cervical cancer treated by direct radical operation during January 2007 to December 2009 were evaluated by NACT for treatment of IB2 cervical cancer. Results The ＂ irinotecan plus nedaplatin＂ chemotherapy had mild adverse reactions, and the total effective rate was 89.09% , and its CR and PR reached 16.36% and 72.72% respectively. The effective rate for squamous cell carcinoma was 75% ; neo - adjuvant chemotherapy for postoperative metastasis in pelvic lymph nodes was 19%. It was significantly lower than that （33.8%） of control group （ P 〈 0.05 ）. The difference in parametrial invasion and positive vaginal margin between these two groups was not statistically significant （ P 〉 0.05 ）. The 3 year cumulative survival rate of neo - adjuvant chemotherapy of 70.12% was significantly higher than that （55.2%） of control group （ P 〈 0.05 ）. Conclusion Neo - adjuvant chemotherapy for locally advanced cervical cancer is safe and effective, it can reduce localized lesions, lower patients＂ clinical stage, improve the operation rate, control of metastasis of pelvic lymph nodes and reduce the complications of chemotherapy and operation.