论文部分内容阅读
目的探讨术前新辅助放化疗对Ⅰb~Ⅱb期宫颈癌近期疗效的影响及其安全性。方法回顾性分析2002年1月至2010年12月经手术治疗的Ⅰb~Ⅱb期宫颈癌118例患者的临床资料。按治疗方法的不同分为直接手术组30例及术前干预(新辅助放化疗)三组:包括术前介入化疗组32例,术前静脉化疗组25例和术前放疗组31例。比较术前新辅助放化疗和直接手术治疗患者的术后客观疗效、病理不良因素发现率、术中出血量及不良反应等。结果直接手术组术后病理不良因素发现率和其中高危因素发现率分别为96.7%和63.3%,明显高于术前介入化疗组(62.5%,37.5%)、静脉化疗组(52.0%,28.0%)和术前放疗组(67.7%,29.0%),差异均有统计学意义(P均<0.05),但术前干预三组间无统计学差异(P>0.05)。直接手术组术中出血量高于其他三组(P均<0.05)。术前介入化疗组、静脉化疗组和放疗组客观有效率分别为59.4%、60.0%、71.0%,组间比较差异无统计学意义(P>0.05)。术前放疗组不良反应发生率45.2%,高于介入化疗组(12.5%,P<0.05)和静脉化疗组(16.0%,P<0.05)。结论术前新辅助放化疗可显著降低Ⅰb~Ⅱb期宫颈癌患者术后病理不良因素和高危因素发现率,减少术中出血量,从而改善患者预后。
Objective To investigate the effect and safety of neoadjuvant radiochemotherapy on the short-term curative effect of stage Ⅰb-Ⅱb cervical cancer. Methods The clinical data of 118 patients with stage Ⅰb ~ Ⅱb cervical cancer who underwent surgery from January 2002 to December 2010 were retrospectively analyzed. According to the different treatment methods, there were 30 cases in direct operation group and 3 cases in preoperative intervention (neoadjuvant radiotherapy and chemotherapy): including 32 cases in preoperative interventional chemotherapy group, 25 cases in preoperative vein chemotherapy group and 31 cases in preoperative radiotherapy group. Objective To compare the postoperative objective curative effect, the detection rate of adverse pathological factors, intraoperative blood loss and adverse reactions of neoadjuvant chemoradiation and direct surgery before operation. Results The detection rate of postoperative pathological adverse factors and the detection rate of high risk factors were 96.7% and 63.3% respectively in the direct operation group, which were significantly higher than those in the preoperative interventional chemotherapy group (62.5%, 37.5%), intravenous chemotherapy group (52.0%, 28.0% ) And preoperative radiotherapy group (67.7%, 29.0%), the differences were statistically significant (all P <0.05), but there was no significant difference among three groups before intervention (P> 0.05). The direct operation group blood loss was higher than the other three groups (all P <0.05). The objective effective rates of preoperative interventional chemotherapy, intravenous chemotherapy and radiotherapy were 59.4%, 60.0% and 71.0%, respectively, with no significant difference between the two groups (P> 0.05). Preoperative radiotherapy group adverse reaction rate was 45.2%, higher than the interventional chemotherapy group (12.5%, P <0.05) and intravenous chemotherapy group (16.0%, P <0.05). Conclusions Neoadjuvant radiochemotherapy before operation can significantly reduce the postoperative morbidity and risk factors of Ⅰb ~ Ⅱb cervical cancer patients, reduce the intraoperative blood loss and improve the prognosis of patients.