Ⅰb2～Ⅱa期巨块型宫颈癌术前同步放化疗的疗效分析

目的：探讨较早期巨块型宫颈癌术前同步放化疗的疗效。方法：将90例Ⅰb2期和Ⅱa期宫颈癌患者随机分为3组，放疗＋小剂量DDP化疗（A）组，放疗＋PF（DDP＋5-Fu）化疗（B）组，单纯放疗（C）组，每组各30例，分析3组近期疗效及毒副反应。结果：术前同步放化疗（A、B）组比放疗（C）组肿瘤退缩明显，总有效率分别为90．0％、93．4％和76．7％，A、B两组分别与C组比较，差异有显著性（P〈0．05），A组与B组比较无差异；术后病理宫颈浸润、宫旁浸润、阴道残端浸润、脉管浸润的发生率同步放化疗（A、B）组均低于单纯放疗（C）组，A组与C组，B组与C组比较，均有显著性差异（P〈0．05），A组与B组间无差异；B组淋巴结转移率为3．3％，明显少于A组和C组，B组与A组，B组与C组分别比较，差异有显著性（P〈0．05）。3组手术时间、术中出血量及毒副反应无显著差异。结论：Ⅰb2～Ⅱa期巨块型宫颈癌术前行同步放化疗疗效优于单纯放疗，以铂类为基础的PF化疗方案可降低淋巴结转移，有助于减少复发，改善预后，值得推广。

Effect of preoperative chemoradiotherapy and radiotherapy for the cases with bulky cervical cancer in stage Ⅰb2 ～Ⅱa

Objective：To evaluate the effect of preoperative chemoradiotherapy and Radiotherapy in early-stage bulky cervical carcinoma. Methods：Total of 90 cases with bulky cervical carcinoma（ FIGO Ⅰb2～Ⅱa） were divided randomly into 3 groups： A group： radiotherapy ＋ DDP（ 30cases）, B groupradiotherapy ＋ PF （ 30cases）, C group ： radiotherapy alone （30cases）. There was no difference of radiotherapy in the three groups. The efficacy and adverse effects of the three groups were compared. Results：The response rates of 3 groups were 90. 0% ,93.4% and 76.7% , there was significant difference between A and C, and between B and C too （P 〈 0. 05） ; Clinical pathology were significant difference between A and C, and between B and C （P 〈0. 05） ,The lymphnode metastasis rate of B group is 3.3% , smaller than A and C, there were significant difference between B and A, and between B and C （ P 〈 0. 05 ） ; There was no significant difference in the time of surgery, bloodloss of surgery and adverse effects of the three groups （ P 〉 0. 05 ）. Conclusion：The patients treated with chemoradiotherapy will get better curative effect than the others with radiotherapy alone; PF chemotherapy is better in chemoradiotherapy.