紫杉醇、异环磷酰胺和顺铂新辅助化疗治疗局部晚期宫颈癌的临床疗效

目的:评估新辅助疗法TIP方案对局部晚期宫颈癌患者的有效性和耐受性.方法:回顾性分析89例晚期宫颈癌患者,其中给予TIP方案治疗患者37例,给予PVB方案治疗患者52例,化疗3周期,4周内行广泛性子宫切除术和盆腔淋巴结清扫术,统计学分析两组治疗方案疗效和不良反应的差异.结果:TIP组和PVB组在近期疗效上差异无统计学意义(P>0.05);TIP组5年总生存率(OS)和无进展生存率(PFS)显著性高于PVB组(86.4% vs 69.2%,X2=12.09,P=0.008;72.9% vs 57.6%,X2=8.15,P=0.020);TIP组在白细胞减少、中性粒细胞减少、血小板减少和贫血方面明显高于PVB组,差异有统计学意义(P<0.05).结论:在治疗局部晚期宫颈癌患者时新辅助疗法TIP方案具有可行性和有效性,同时也应谨慎预防血液学毒性.

The clinical curative effect analysis of neoadjuant chemotherapy with paclitaxel,ifosfamide and cisplatin in locally advanced cervical cancer

Objective:To evaluate the efficacy and tolerability of the TIP regimen(paclitaxel,ifosfamide and cisplatin) in the neoadjuvant treatment of locally advanced squamous cell cervical cancer.Methods:To retrospectively analyse 89 cases of patients with locally advanced cervical carcinoma.Patients were treated with TIP regimen and PVB regimen for three cycles,followed by radical hysterectomy and pelvic lymphadenectomy within 4 weeks.The difference of curative and adverse effect between groups were assessed by statistical analysis.Results:TIP group and PVB group were no significant difference in the short-term effect(P>0.05).The 5-year overall survival and progression-free survival in TIP group were significantly higher than PVB group(86.4% vs 69.2%,X2=12.09,P=0.008;72.9% vs 57.6%,X2=8.15,P=0.020).TIP group was significantly higher than PVB group in leukopenia,neutropenia,thrombocytopenia and anemia(P<0.05) Conclusion:Neoadjuvant of TIP regimen was feasible and effective in the treatment of locally advanced cervical carcinoma patients with older age and more advanced disease stage than reported in previous studies.Hematological toxicity could be carefully prevented.