PVB和TP方案对局部晚期宫颈癌患者的治疗效果及预后的比较

目的 探讨局部晚期宫颈癌患者经过PVB和TP化疗方式治疗的效果和预后的情况.方法 收集128例局部晚期宫颈癌患者的临床相关资料,其中68例进行TP方案化疗(顺铂+紫杉醇),另外60例进行PVB方案化疗(顺铂+长春新碱+博莱霉素),化疗后进行手术.统计2组患者的近期疗效、术后病理情况以及不良反应发生情况.结果 在TP组中,鳞癌患者的治疗有效率为85.0％,非鳞癌患者的治疗有效率为76.9％;而在PVB组中,鳞癌患者的治疗有效率为72.2％,非鳞癌患者的治疗有效率为45.8％.TP组非鳞癌患者的有效率显著高于PVB组非鳞癌患者,差异有统计学意义(P＜0.05).在淋巴结、脉管转移发生率和宫旁切缘、阴道切缘阳性率方面,PVB组和TP组无统计学差异(P＞0.05).在血液系统不良反应方面,红细胞减少和血小板减少发生情况2组不存在统计学差异(P＞0.05),TP组患者的骨髓抑制发生率显著低于PVB组患者(P＜0.05);在非血液系统不良反应方面,放射性损伤、胃肠道反应、周围神经毒性和肝肾功能损害发生情况2组均不存在统计学差异(P＞0.05).结论 局部晚期宫颈癌患者术前进行TP方案化疗的近期疗效优于PVB方案,特别是非鳞癌患者.在改善预后方面两种方案一致,但TP方案毒副作用高于PVB方案.

Efficacy and Prognosis of PVB and TP Chemotherapy for Locally Advanced Cervical Cancer

Objective To study the efficacy and prognosis of PVB and TP chemotherapy for locally advanced cervical cancer.Methods Clinical data of 128 cases of patients with locally advanced cervical cancer were collected,including 68 patients with TP chemotherapy(cisplatin plus paclitaxel),60 patients were treated with PVB scheme chemotherapy(cisplatin + vincristine + lai toxin),surgery after chemotherapy.Statistics of the recent efficacy of the 2 groups,postoperative pathological conditions as well as the occurrence of adverse reaction.Results In the TP group,the treatment of patients with squamous carcinoma of the effective rate was 85.0％,not the treatment of patients with squamous carcinoma of the effective rate was 76.9％;In the PVB group,the treatment of patients with squamous carcinoma of the effective rate was 72.2％,the treatment of patients with squamous carcinoma of the effective rate was 45.8％.Efficiency of TP group was significantly higher than PVB group,the difference was statistically significant (P ＜ 0.05).In the lymph nodes,the incidence of vascular metastasis and palace next to the cutting edge,vaginal cut edge positive aspects,PVB and TP groups there was no significant difference (P ＞ 0.05);In the aspect of adverse reaction of the blood,red blood cells to reduce and thrombocytopenia occurring situation of the 2 groups of patients,there was no significant difference(P ＞ 0.05),TP group had a significantly higher incidence of bone marrow suppression in patients with PVB group of patients (P ＜ 0.05);In the aspect of adverse reaction of the blood,radiation damage,gastrointestinal reaction and peripheral nerve toxicity and function of liver and kidney damage was happening,there was no significant difference in both groups (P ＞ 0.05).Conclusion For patients with locally advanced cervical cancer on preoperative TP plan of chemotherapy short-term curative effect is superior to the PVB,especially not squamous carcinoma patients,the 2 kinds of scheme in improving its prognosis have similar effect,but TP plan toxicity is lower than the PVB.