新辅助化疗和放疗在局部晚期子宫颈癌治疗中的比较

目的:观察比较新辅助化疗和放疗治疗局部晚期宫颈癌的疗效及影响疗效的相关因素,以及对患者长期生存的影响。方法:收集1999年4月年3月在山东省日照市人民医院、日照市中医院、山东省淄博市周村区人民医院行新辅助化疗的局部晚期或巨块型宫颈癌患者73例,分析其临床病理资料和化疗后的疗效;并对同期行放疗的局部晚期或巨块型宫颈癌51例,分析其临床病理资料和化疗后的疗效。分析比较新辅助化疗和放疗治疗的效益。结果:新辅助化疗的总有效率为79.46%(58/73),放疗的总有效率为49.02%(25/51)。新辅助化疗患者的疗效与病理类型有关,鳞癌患者的有效率为81.36%(48/59)明显高于腺癌54.17%(13/24,P<0.05);而与其他因素无关(P<0.05);放疗患者的疗效也与病理类型有关,鳞癌患者的有效率为51.35%(19/37)明显高于腺癌42.86%(6/14)。新辅助化疗有效者手术后盆腔淋巴结阳性率为8.62%(5/58),宫旁血管癌栓阳性率为3.45%(2/58),均明显低于新辅助化疗无效者(分别为6/15,5/15;P<0.05)。放疗有效者手术后盆腔淋巴结阳性率为16%(4/25),宫旁血管癌栓阳性率为12%(3/25),均明显高于新辅助化疗有效者。结论:新辅助化疗和放疗局部晚期宫颈癌的疗效与病理类型有关,新辅助化疗优于放疗,对化疗和放疗有效者应选择手术,可提高长期生存率。

The effect of company neoadjuvant chemotherapy with radiotherapy on locally advanced cervical cancer

Objective:To investigate the effect of neoadjuvant chemotherapy and radiotherapy on locally advanced cervical cancer,and the effect on survival,to study the correlation factor of clinical effect.Methods:Patients from Apirl 1999 to March 2005 in Shandong Zibo Zhoucun District and Rizhao People's hospital who suffered from locally advanced cervical cancer or bulky tumor were studied.73 patients were treated with neoadjuvant therapy and 51 patients were treated with radiotherapy.The information of clinical and pathology and curative effect of after neoadjuvant chemotherapy were analyzed.The role of neoadjuvant chemotherapy and radiotherapy were compared.Results:It is resulted that overall clinical response of neoadjuvant chemotherapy and radiotherapy was79.46%(53/73)and 49.02(25/51)respectively.The effect of neoadjuvant chemotherapy was corelated with pathological classification.The effective power of squamous carcinoma was 81.36%(48/59),higher than adenocarcinoma,54.17%(13/24,P<0.05);and there had no relationship with other factors.The effect of radiotherapy was also corelated with pathological classification.The effective power of squamous carcinoma was 51.35%(19/37),higher than adenocarcinoma,42.86%(6/14).The positive rate of pelvis lymphnode of effective neoadjuvant chemotherapy patients was 8.62%(5/58),.The positive rate of parauterus vessel carcinoma embolus was 3.45%(2/58),both lower than ineffective neoadjuvant chemotherapy patients(6/15,5/15,P<0.05,respectively).The positive rate of pelvis lymphnode of effective radiotherapy patients was 16%(4/25).The positive rate of parauterus vessel carcinoma embolus was 12%(3/25),both higher than effective neoadjuvant chemotherapy patients.Conclusion:The effect of radiotherapy and neoadjuvant chemotherapy were corelated with pathological classification.Neoadjuvant chemotherapy was better than radiotherapy.Operation could improve long survival rate for effective neoadjuvant chemotherapy and radiotherapy patients.