经动脉新辅助化疗治疗局部晚期宫颈癌的临床价值

目的评价经动脉新辅助化疗（neoadjuvant intra—arterial chemotherapy，NAIC）治疗宫颈癌的临床疗效。方法选择2000年2月至2003年2月在本院确诊为局部晚期宫颈癌Ⅰb2～Ⅱb期，并符合经动脉新辅助化疗＋手术治疗适应证的患者86例为研究对象。将其随机分为NAIC组（n=43）和单纯手术组（n=43）（本研究疗程符合南充市中心医院人体试验委员会制定的伦理学标准，得到该委员会批准，且分组征得受试对象的知情同意，并与之签署临床研究知情同意书）。对NAIC组和单纯手术组的手术时间，术中出血量、术后并发症及5年生存率等进行对比分析。结果经动脉新辅助化疗＋手术治疗较单纯手术具有手术时间短、术中出血量少、术后并发症低、术后5年生存率高（148．0±17．8）min vs．（182．0±20．1）min；（350．0±21．5）mL vs．（480．0±23．6）mL；2．3％ vs ；18．6％；79％vs．58％）]等优点，两组比较，差异有显著意义（P〈0．05）。结论经动脉新辅助化疗＋手术治疗局部晚期宫颈癌，可控制肿瘤微小浸润，减小肿瘤体积，提高手术切除率及患者5年生存率。

Clinical Effects of Neoadjuvant Intra-Arterial Chemotherapy for Locally Advanced Cervical Cancer

Objective To evaluate clinical effects of neoadjuvant intra-arterial chemotherapy for locally advanced cervical cancer. Methods From February 2000 to February 2003, 86 patients who were diagnosed as locally advanced cervical cancer Ⅰb2- Ⅱb and conformed to the indications of neoadjuvant intra-arterial chemotherapy ＋ surgery were included in this study. They were randomly divided into NAIC group （n ： 43, neoadjuvant intra-arterial chemotherapy ＋ surgery） and pure surgery group （n： 43 ）. Informed consent was obtained from all participates. Duration of surgery time, volume of bleeding, incidence rate of complications and five-year survival rate were measured between two groups. Results Duration of surgery time （148.0±17.8） min vs. （182.0±20. 1） mini, volume of bleeding （350. 0± 21.5） mL vs. （480.0±23. 6） mL], incidence rate of complications（2. 3% vs. 18. 6%） and five-year survivalrate（79% vs. 58%） were better in NAIC group than those of pure surgery group（P〈0. 05）. Conclusion Neoadjuvant intra-arterial chemotherapy ＋ surgery can control microinvasive carcinoma, reduce the size of tumor, increase the resection rate, and improve five-year survival rate of patients with locally advanced cervical cancer.