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目的探讨术前新辅助化疗对巨块型宫颈鳞癌的疗效。方法选择2000年3月至2003年3月山西省肿瘤医院妇科住院的Ⅰb～Ⅱb期巨块型宫颈鳞癌患者100例,随机分成观察组与对照组各50例。观察组50例给予PVB方案化疗:顺铂(DDP)30mg/d,第1～3天静脉滴注,长春新碱(VCR)1mg/d,第1天静脉滴注,博来霉素(BLM)15mg/d,第1～3天静脉滴注。新辅助化疗组患者均接受1个疗程化疗,停药7d后行子宫广泛切除加盆腔淋巴结清扫术,对照组直接予子宫广泛切除加盆腔淋巴结清扫术。两组术后进行疗效评定及生存率比较。结果观察组临床有效为38例(78%),其中完全缓解8例,Ⅰb2、Ⅱa、Ⅱb期患者化疗后临床有效率分别为22/26(85%)、12/15(80%)、4/9(44%),与对照组比较差异有统计学意义(P<0.05)。化疗组3年复发率明显低于对照组(P<0.05);而两组3年生存率比较差异无统计学意义(P>0.05)。结论宫颈癌根治术前采用PVB方案进行化疗,对Ⅰb～Ⅱb期巨块型宫颈鳞癌具有较高临床疗效,并明显提高了患者的3年无瘤生存率。
Objective To investigate the effect of preoperative neoadjuvant chemotherapy on massive cervical squamous cell carcinoma. Methods A total of 100 patients with stage Ⅰb ~ Ⅱb giant cervical squamous cell carcinoma admitted to Gynecology Department of Shanxi Cancer Hospital from March 2000 to March 2003 were randomly divided into observation group (50 cases) and control group (50 cases). Patients in the observation group were given PVB chemotherapy: cisplatin (DDP) 30 mg / d, intravenous drip on days 1 to 3, vincristine (VCR) 1 mg / d, intravenous drip on day 1, bleomycin ) 15mg / d, 1 to 3 days intravenous drip. Patients in neoadjuvant chemotherapy group received a course of chemotherapy, and extensive uterine resection combined with pelvic lymphadenectomy was performed 7 days after stopping the treatment. The control group was treated with extensive resection of the uterus and pelvic lymphadenectomy. The curative effect and the survival rate of two groups were compared after operation. Results The clinical efficacy of the observation group was 38 cases (78%), of which 8 cases were completely relieved. The clinical effective rates of patients in group Ⅰb2, Ⅱa and Ⅱb after chemotherapy were 22/26 (85%), 12/15 (80%), / 9 (44%) compared with the control group, the difference was statistically significant (P <0.05). The 3-year recurrence rate in the chemotherapy group was significantly lower than that in the control group (P <0.05). There was no significant difference in the 3-year survival rates between the two groups (P> 0.05). Conclusion The chemotherapy of PVB before radical surgery for cervical cancer has high clinical effect on stage Ⅰb ~ Ⅱb giant cervical squamous cell carcinoma and significantly improves the 3-year disease-free survival rate of patients.