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目的探讨新辅助化疗治疗局部晚期宫颈癌的近期疗效。方法将80例局部晚期宫颈癌患者随机分为观察组(新辅助化疗组)和对照组(常规手术组),每组各40例。观察组患者予PBV方案化疗1～2个疗程后进行根治手术,对照组患者直接进行根治手术。比较化疗前后观察组患者肿瘤变化情况及两组患者的术后淋巴结转移、脉管癌栓、宫颈浸润、出血量、手术时间情况及不良反应。结果化疗后观察组患者肿瘤大小明显小于化疗前,差异有统计学意义(P<0.05),化疗后进展1例,稳定8例,部分缓解25例,完全缓解6例,治疗总有效率为77.50%;观察组和对照组患者的手术时间分别为(188.56±32.14)min和(279.28±45.27)min(P<0.05),术中出血量分别为(568.96±206.33)ml和(816.55±229.85)ml(P<0.05),宫颈深层间质浸润发生率分别为57.50%和65.00%(P>0.05),脉管癌栓发生率分别为25.00%和27.50%(P>0.05),淋巴结转移率分别为27.50%和35.00%(P<0.05)。结论新辅助化疗治疗局部晚期宫颈癌能提高近期疗效,减少淋巴结转移率和术中出血量,减少手术时间,减小肿瘤大小。
Objective To investigate the effect of neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer. Methods Eighty patients with locally advanced cervical cancer were randomly divided into observation group (neoadjuvant chemotherapy group) and control group (conventional surgery group), 40 cases in each group. The patients in the observation group were treated with PBV regimen for 1 ~ 2 courses of radical surgery and the control group of patients undergoing radical surgery. The changes of tumor in the observation group before and after chemotherapy and the postoperative lymph node metastasis, vascular cancer emboli, cervical infiltration, blood loss, operation time and adverse reactions in both groups were compared. Results After chemotherapy, the tumor size in observation group was significantly smaller than that before chemotherapy (P <0.05). One case was cured after chemotherapy, 8 cases stabilized, 25 cases partially relieved and 6 cases completely relieved. The total effective rate was 77.50 %. The operation time of the observation group and the control group were (188.56 ± 32.14) min and (279.28 ± 45.27) min (P <0.05), and the intraoperative blood loss were 568.96 ± 206.33 ml and 816.55 ± 229.85, (P <0.05). The incidence of deep cervical interstitial infiltration was 57.50% and 65.00% respectively (P> 0.05). The incidences of vascular tumor thrombus were 25.00% and 27.50%, respectively 27.50% and 35.00% (P <0.05). Conclusion Neoadjuvant chemotherapy for locally advanced cervical cancer can improve the short-term efficacy, reduce the rate of lymph node metastasis and intraoperative blood loss, reduce the operation time and reduce the size of the tumor.