术前新辅助化疗治疗局部晚期宫颈癌临床疗效的观察

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1、肿瘤基础与临床2011年6月第24卷第3期·213·术前新辅助化疗治疗局部晚期宫颈癌临床疗效的观察11112侯岩峰，程晓伟，承莉，俞小元，万美珍(1．苏州大学附属常州市肿瘤医院妇瘤科;2．病理科，江苏常州213001)摘要:目的探讨Ⅰb2～Ⅱb期局部晚期宫颈癌于根治术前给予新辅助化疗(NACT)的疗效。方法回顾性分析48例Ib2～Ⅱb期局部晚期宫颈癌NACT1～2疗程后根治性手术者(NACT组)和38例直接根治性手术者(对照组)的临床资料，评价NACT在宫颈癌治疗中的作用及安全性。结果术前NACT总有效率77．1%，化疗毒副反应轻。NACT组宫旁及阴道切缘阳性率低

2、于对照组(P＜0．05)。两组手术时间、术中出血量、术后留置尿管时间、并发症发生率比较差异无统计学意义(P＞0．05)。结论Ⅰb2～Ⅱb期局部晚期宫颈癌术前NACT效果好，能使肿瘤病灶缩小，宫旁组织浸润消退，为根治性手术创造条件。关键词:宫颈癌;新辅助化疗;宫颈癌根治术中图分类号:R737．33;R730．53文献标识码:A文章编号:1673－5412(2011)03－0213－03TheClinicalObservationoftheTherapeuticEffectofNeoadjuvantChemotherapyonPatientswithLocalAdva

3、ncedCervicalCarcinomaHouYanfeng，ChengXiaowei，ChengLi，YuXiaoyuan，WanMeizhen(1．DepartmentofGynecologyandOncology;2．DepartmentofPathology，ChangzhouTumorHospitalAffiliatedtoSoochowUniversity，Changzhou213001，China)Abstract:ObjectiveToexploretheclinicaltherapeuticeffectofneoadjuvantchemothe

4、rapy(NACT)onlocallyadvancedstageIb2-Ⅱbcer-vicalcarcinoma．MethodsWeretrospectivelyanalyzed48patientswithbulkystagerⅠb2-Ⅱbcervicalcarcinoma(theNACTgroup)whore-ceived1-2coursesoftreatmentwithNACTandthenunderwentradicalhysterectomyinallofthem，and38patiens(thecontrolgroup)whore-ceivedradic

5、alhysterectomy．Theeffectandsafetyofchemotherapyonthetreatmentofcervicalcarcinomawereassessed(bythelesionsize，toxicties，operativestatus，andpathology)．ResultsTheeffectiverateofNACTwas77．1%，andthetoxictieswereweak．AfterthetreatmentwithNACT，thepathologicalparametrialandvaginaedgepositiver

6、ateintheNACTgroupwassignificantlylowerthanthatinthecontrolgroup(P＜0．05)．Therewerenosignificantdifferencesinsurgerytime，bloodloss，indwellingcathetertimeandtheincidenceratesofcomplicationsbetweenthesetwogroups(P＞0．05)．ConclusionPreoperativeNACTiseffectiveforlocallyadvancedstageⅠb2-Ⅱbcer

7、vicalcarcinoma，candiminishtumorsize，decreasetumortissueinfiltration，andcreatethegoodconditionstoradicalsurgery．Keywords:cervicalcarcinoma;neoadjuvantchemotherapy;radicalhysterectomyofcervicalcancer子宫颈癌是女性最常见的恶性肿瘤之一，死亡率在我院妇科住院、通过病理及临床确诊、分期为Ⅰb2较高。临床上治疗多采用手术和放疗治疗，但对局部～Ⅱb期的局部晚期宫颈癌患者48例(NA

8、CT组)，