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目的探讨新辅助化疗对早期巨块型子宫颈癌的疗效。方法对大连医科大学附属第一医院妇产科2002年1月～2005年5月间收治的15例Ⅰb～Ⅱb期局部肿块直径≥4cm的宫颈癌患者,术前给予以铂类为基础的联合方案化疗1～2个疗程,后行广泛性子宫切除术和盆腔淋巴结清扫术,观察化疗后局部肿瘤体积的变化和盆腔淋巴结转移、宫颈浸润深度及标本切缘肿瘤浸润情况,随访治疗后的生存状况。结果15例患者术前化疗后,宫颈局部肿瘤均有不同程度的缩小,14例临床有效,总临床反应率93.3%,12例进行了根治性手术,手术率80%。结论宫颈癌术前新辅助化疗可改善临床症状,减小肿瘤的体积和范围,降低肿瘤临床分期,提高手术率,但新辅助化疗能否有效早期控制淋巴或脉管的微小转移灶和亚临床病灶及其对总体生存率的意义需长时间、大样本的随访。
Objective To investigate the effect of neoadjuvant chemotherapy on early giant cervical cancer. Methods Fifteen cases of cervical cancer with the diameter of 4 cm or more in stage Ⅰb-Ⅱb were treated in the Department of Obstetrics and Gynecology, the First Affiliated Hospital of Dalian Medical University from January 2002 to May 2005. The patients were treated with platinum-based combination The regimens were treated with 1 ~ 2 courses of chemotherapy. After radical hysterectomy and pelvic lymphadenectomy, the changes of local tumor volume and pelvic lymph node metastasis, the depth of cervical invasion and the marginal tumor invasion were observed. The survival after follow-up situation. Results Fifteen patients underwent preoperative chemotherapy. The local cervical tumors were reduced to varying degrees. Of the 15 patients, 14 were clinically effective and the overall clinical response rate was 93.3%. Twelve patients underwent radical surgery with an operation rate of 80%. Conclusion Neoadjuvant chemotherapy before cervical cancer can improve the clinical symptoms, reduce the size and scope of the tumor, reduce the clinical staging of the tumor and improve the operation rate. However, whether neoadjuvant chemotherapy can effectively control the micrometastases of lymph nodes or vasculature and subclinical Lesions and their implications for overall survival require prolonged, large sample follow-up.