三种不同化放疗方法对宫颈癌患者术前辅助治疗效果对比研究

目的观察子宫动脉灌注栓塞化疗、全身静脉化疗和体外放疗在宫颈癌Ⅰb2期到Ⅱb期患者术前辅助治疗中的疗效。方法选择2017年1月至2020年1月在眉山市人民医院妇科收治的原发性宫颈癌患者220例,在行手术治疗前,依据治疗方式分为子宫动脉灌注栓塞化疗组72例,全身静脉化疗组75例和体外放疗组73例,术后1个月观察3组患者的近期临床症状缓解、肿块消退情况及胃肠道不良反应发生情况。结果治疗1个月后,(1)三组患者临床症状均有不同程度缓解,子宫动脉灌注栓塞化疗组总缓解率83.33%(60/72)优于全身静脉化疗组68.00%(51/75)和体外放疗组64.38%(47/73),P值均<0.05;(2)子宫动脉灌注栓塞化疗组患者的肿块消退情况明显优于全身静脉化疗组和体外放疗组,子宫动脉灌注栓塞化疗组的总有效率为87.50%(63/72),明显高于全身静脉化疗组的72.00%(54/75)和体外放疗组的68.49%(50/73),P值均<0.05;(3)子宫动脉灌注栓塞化疗组的无反应比例43.06%(31/72)明显高于体外放疗组20.55%(15/73),P值均<0.05。结论子宫动脉灌注栓塞化疗联合手术治疗能有效控制Ⅰb2期到Ⅱb期宫颈癌患者病情的发展,能提高近期临床症状缓解率,疗效优于全身静脉化疗及体外放疗,且胃肠道不良反应发生率低。

A comparative study of the effect of three different chemoradiotherapy on the preoperative adjuvant treatment of cervical cancer patients

Objective To observe the efficacy of uterine artery perfusion embolization chemotherapy,systemic intravenous chemotherapy,and extracorporeal radiotherapy in preoperative adjuvant therapy in patients with cervical cancer stagesⅠb2 toⅡb.Methods A total of 220 patients with primary cervical cancer admitted to the gynecology department of Meishan People′s Hospital from January 2017 to January 2020 were selected and divided into 72 cases of uterine artery perfusion embolization chemotherapy group,75 cases of systemic intravenous chemotherapy group and 73 cases of extracorporeal radiotherapy group according to their treatment before surgery,and the recent clinical symptom relief,mass regression and the occurrence of gastrointestinal adverse reactions in the three groups were observed one month after surgery.Results After 1 month of treatment,(1)all 3 groups of patients had varying degrees of clinical remission,and the uterine artery perfusion embolization chemotherapy group had total remission rate 83.33%,which was better than 68.00%in the systemic intravenous chemotherapy group and 68.00%in the extracorporeal radiotherapy group 64.38%;(2)patients in the uterine artery perfusion embolization chemotherapy group had significantly better mass regression than the whole body.The overall effective rate of uterine artery perfusion embolization chemotherapy was 87.50%in the intravenous chemotherapy and extracorporeal radiotherapy groups,which significantly higher than 72.00%in the systemic intravenous chemotherapy group and 68.49%in the extracorporeal radiotherapy group.(3)the nonresponse rate in the uterine artery perfusion embolization chemotherapy group 43.06%was significantly higher than 20.55%in the extracorporeal radiotherapy group,the above difference,the comparisons were statistically significant(P<0.05).Conclusion Uterine artery perfusion embolization chemotherapy combined with surgery can effectively control the development of cervical cancer patients from stageⅠb2 to stageⅡb,and can improve the short-term clinical symptoms remission rate,the efficacy is superior to systemic intravenous chemotherapy and external radiotherapy with low incidence of gastrointestinal adverse reactions.