资源描述：
《巨块型宫颈癌新辅助化疗临床观察》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、巨块型宫颈癌新辅助化疗临床观察作者：潘凤莲，唐羿，周莉单位：湖北荆州第二人民医院，湖北荆州434000【摘要】目的：评价新辅助化疗治疗巨块型宫颈癌的可行性、疗效、毒性及对患者远期生存率的影响。方法：回顾性分析我院1999年6月〜2008年10月收治的145例巨块型宫颈癌患者临床资料，将其分为两组，新辅助化疗组65例，给予顺钳(DDP)60〜80mg+表阿霉素(EPI)50〜80mg1〜2个疗程的动脉介入化疗;对照组80例为单纯手术组，直接行广泛子宫切除术加盆腔淋巴结清扫术。新辅助化疗组2周后判断局部肿瘤体
2、积的变化，并根据术后病理检查比较两组盆腔淋巴结转移、宫颈管浸润、宫旁浸润、阴道切缘肿瘤浸润，分析治疗后的近期疗效及累积生存率。结果：新辅助化疗2周后总有效率为76.9%,其中完全缓解占13.8%,部分缓解占63.1%,病情稳定/病情进展占23.1%;新辅助化疗组术后盆腔淋巴结转移为19.0%,明显低于对照组(33.8%,P=0.041),宫颈管浸润、宫旁浸润、阴道切缘阳性两组差异无统计学意义(P值分别为0.121、0.142和0.334);新辅助化疗组5年累积生存率(70.12%)明显高于对照组(55.2
3、6%)(P=0.04)。结论：新辅助化疗治疗巨块型宫颈癌安全有效，可缩小局部病灶，降低部分患者临床分期，提高手术率，控制盆腔淋巴结转移，并减少化疗并发症或手术并发症的发生。【关键词】宫颈肿瘤;药物疗法;辅助;预后EffectofneoadjuvantchemotherapyonbulkycervicalcarcinomaPANFenglian,TANGYi,ZHOULi(The2ndPeople，sHospitalinJingzhouJingzhou434000,China)[ABSTRACT]Objec
4、tive:Toevaluatethefeasibility,efficacy,toxicitythesurvivalrateofneoadjuvantchemotherapyforbulkycervicalcancer・Methods：BetweenJune1999andOctober2008,145patientswithbulkycancerofthecervixwereseparatedintotwogroups,65patientsinneoadjuvantchemotherapygroup,wh
5、oreceivedneoadjuvantchemotherapywithDDP60~80mgandEPI50〜80mgforoneortwocoursesofchemotherapyfollowedbyradicalhysterectomyandpelviclymphadenectomyafter2or3weeks,and80patientsascontrolgroupwhoweretreatedwithradicalsurgeryalone.Thegrosstumorvolumewasassessed・
6、Lymphoidnodemetastasis,involvementofcervicalcanals,parametrialinvasionandpositivesurgicalmarginsofthevaginawereassessedaccordingtothepostoperativepathologytest,aswe11assumsurvivalratewasanalyzed.ResuIts：After2weekswithneoadjuvantchemotherapy,efficacyratei
7、nneoadjuvantchemotherapygroupwas76.9%,13.8%ofpatientsinthisgroupcompleteremission,63.1%ofpatientshadpartialremission,23.1%wereinstableorprogressedstatus・TheLymphoidnodemetastasisratewassignificantlyhigherincontrolgroupthantheneoadjuvantchemotherapygroupaf
8、terradicalhysterectomyandpelviclymphadenectomy(P二0.041).Involvementofcervicalcanal,parametrialinvasionandpositivesurgicalmarginsofthevaginaratewerehigherincontrolgroupthantheneoadjuvantchemotherapygroup,butthediffer
