新輔助化學療法對早期巨塊型宮頸癌近期療效分析_《華西醫學》

作者：

周平

宜興市人民醫院（江蘇宜興，214200）;

關鍵詞：

宮頸腫瘤新輔助化療近期療效

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【摘要】　目的　評價早期巨塊型宮頸癌患者術前行新輔助化學療法的近期療效。　方法　回顧分析2005年10月-2010年6月收治的Ⅰb~Ⅱa期巨塊型宮頸癌患者90例患者的臨床資料。根據術前是否行化學療法將患者分為兩組；新輔助化學療法（neoadjuvant chemotherapy，NACT）組50例，術前予靜脈化學療法或子宮動脈灌注化學療法治療1～3個療程;直接手術組40例，直接行根治性手術。比較新輔助化學療法前后病灶大小變化，化學療法不良反應，手術情況及術后病理情況。　結果　 NACT組總有效率86%（43/50），鱗癌療效優于腺癌，動脈與靜脈化學療法近期有效率比較，兩組差異無統計學意義（P gt;0.05）。NACT不良反應小。NACT組術中出血少于直接手術組，兩者差異有統計學意義（P lt;0.05）。兩組深肌層浸潤、淋巴結轉移、脈管浸潤差異均無統計學意義（P gt;0.05），NACT組宮旁浸潤率低于直接手術組。　結論　術前NACT對早期巨塊型宮頸癌患者近期療效顯著。
【Abstract】　Objective　 To evaluate the short-term curative effect of preoperative neoadjuvant chemotherapy on the early-stage bulky cervical carcinoma. 　Methods　 We retrospectively analyzed the clinical data of 70 patients with bulky ⅠB-ⅡA cervical carcinoma treated in our hospital between October 2005 and June 2010. Based on whether the patients received chemotherapy, they were divided into two groups: neoadjuvant chemotherapy group (NACT group) and direct surgery group. In the former group, there were 50 patients who underwent surgery after 1 to 3 cycles of preoperative chemotherapy by uterus artery infusion or intravenous chemoembolization. For the 40 patients in the latter group, direct radical surgery was performed. The size of the tumor before and after chemotherapy, the operation conditions and the postoperative pathological conditions of patients between the two groups were compared and the adverse reactions of neoadjuvant chemotherapy were analyzed as well.　Results　 The total effective rate of NACT group was 86% (43/50). The response to chemotherapy in squamous cell caner was significantly higher than adenocarcinoma. There was no statistical difference between arterial and venous chemotherapy in terms of immediate effect (P gt;0.05). The incidence of adverse reactions of neoadjuvant chemotherapy was low. There was significant difference between the NACT group and the direct surgery group in intraoperative bleeding (P lt;0.05). There were no significant differences between the above two groups in deep muscularis infiltration rate, lymph node metastasis rate and vascular invasion rate. However, the parametrial infiltration rate for the NACT group was lower than that for the direct surgery group.　Conclusion　 Preoperative neoadjuvant chemotherapy on patients with early-stage bulky cervical carcinoma has a remarkable immediate curative effect.

引用本文： 周平. 新輔助化學療法對早期巨塊型宮頸癌近期療效分析. 華西醫學, 2011, 26(4): 517-520. doi: 復制

1.	Hockel M, Dornhofer N. The hydra phenomenon of cancer: why tumors recur locally after microscopically complete resection[J]. Cancer Res, 2005, 65(8): 2997-3002.
2.	陳敏, 李玉萍, 梁月華. 宮頸癌新輔助動脈化療臨床療效觀察[J]. 中國實用婦科與產科雜志, 2007, 23(9): 718-719.
3.	凌斌, Bin L. 子宮頸癌診斷與治療的新進展[J]. 中國實用婦科與產科雜志, 2007, 23(1): 23-25.
4.	程曉東, 呂衛國, 葉楓, 等. 局部晚期子宮頸癌新輔助化療價值的評估[J]. 中華婦產科雜志, 2006, 41(2): 95-98.
5.	Mizuno K, Kidokoro K, Miyazaki K, et al. Neoadjuvant chemotherapy with intra-arterial infusion in the treatment of advanced cervical cancer[J]. Gan To Kagaku Ryoho, 2005, 32(6): 815-819.
6.	王文, 蔣國慶, 高敏, 等. 術前新輔助化療對宮頸癌患者臨床療效的初步觀察[J]. 中國婦產科臨床雜志,2009,10(2): 105-108.
7.	常麗錦, 王建六, 魏麗惠. 子宮頸癌的新輔助化療[J]. 現代婦產科進展, 2003, 12(2): 135-136.
8.	徐麗萍, 邵華江. 35例ⅠB2～ⅡB期宮頸癌術前介入治療臨床分析[J]. 實用婦產科雜志, 2009, 25(5): 296-298.
9.	Park DC, Kim JH, Lew YO, et al. Phase II trial of neoadjuvant paclitaxel and cisplatin in uterine cervical cancer[J]. Gynecol Oncol, 2004, 92(1): 59-63.
10.	王平, 彭芝蘭, 張家文, 等. 子宮頸癌新輔助化療中不同化療途徑的療效比較[J]. 中華婦產科雜志, 2005, 40(4): 227-230.
11.	任亞娟, 糜若然. 宮頸癌新輔助化療臨床應用及預后影響因素[J]. 國外醫學(婦產科學分冊), 2007, 34(6): 415-418.
12.	Choi YS, Sin JI, Kim JH, et al. Survival benefits of neoadjuvant chemotherapy followed by radical surgery versus radiotherapy in locally advanced chemoresistant cervical cancer[J]. J Korean Med Sci, 2006, 21(4): 683-689.

1. 　Hockel M, Dornhofer N. The hydra phenomenon of cancer: why tumors recur locally after microscopically complete resection[J]. Cancer Res, 2005, 65(8): 2997-3002.
2. 　陳敏, 李玉萍, 梁月華. 宮頸癌新輔助動脈化療臨床療效觀察[J]. 中國實用婦科與產科雜志, 2007, 23(9): 718-719.
3. 　凌斌, Bin L. 子宮頸癌診斷與治療的新進展[J]. 中國實用婦科與產科雜志, 2007, 23(1): 23-25.
4. 　程曉東, 呂衛國, 葉楓, 等. 局部晚期子宮頸癌新輔助化療價值的評估[J]. 中華婦產科雜志, 2006, 41(2): 95-98.
5. 　Mizuno K, Kidokoro K, Miyazaki K, et al. Neoadjuvant chemotherapy with intra-arterial infusion in the treatment of advanced cervical cancer[J]. Gan To Kagaku Ryoho, 2005, 32(6): 815-819.
6. 　王文, 蔣國慶, 高敏, 等. 術前新輔助化療對宮頸癌患者臨床療效的初步觀察[J]. 中國婦產科臨床雜志,2009,10(2): 105-108.
7. 　常麗錦, 王建六, 魏麗惠. 子宮頸癌的新輔助化療[J]. 現代婦產科進展, 2003, 12(2): 135-136.
8. 　徐麗萍, 邵華江. 35例ⅠB2～ⅡB期宮頸癌術前介入治療臨床分析[J]. 實用婦產科雜志, 2009, 25(5): 296-298.
9. 　Park DC, Kim JH, Lew YO, et al. Phase II trial of neoadjuvant paclitaxel and cisplatin in uterine cervical cancer[J]. Gynecol Oncol, 2004, 92(1): 59-63.
10. 　王平, 彭芝蘭, 張家文, 等. 子宮頸癌新輔助化療中不同化療途徑的療效比較[J]. 中華婦產科雜志, 2005, 40(4): 227-230.
11. 　任亞娟, 糜若然. 宮頸癌新輔助化療臨床應用及預后影響因素[J]. 國外醫學(婦產科學分冊), 2007, 34(6): 415-418.
12. 　Choi YS, Sin JI, Kim JH, et al. Survival benefits of neoadjuvant chemotherapy followed by radical surgery versus radiotherapy in locally advanced chemoresistant cervical cancer[J]. J Korean Med Sci, 2006, 21(4): 683-689.

《華西醫學》

新輔助化學療法對早期巨塊型宮頸癌近期療效分析

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《華西醫學》

新輔助化學療法對早期巨塊型宮頸癌近期療效分析

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Content

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