论文部分内容阅读
[目的]探讨动脉灌注新辅助化疗(NACT)对宫颈癌治疗的价值。[方法]选择87例Ⅰb2～Ⅱb期宫颈癌患者,随机分为直接手术组(43例)和动脉灌注NACT组(44例)。观察动脉灌注NACT组在治疗前后肿瘤大小的变化和不良反应;比较两组手术时间、手术过程出血量、手术后病理特征差异。[结果]动脉灌注NACT组中CR9例,PR22例,有效率为70.45%;化疗有效率与患者年龄、分期、分化程度无关,而与病理类型和肿块大小有关(P<0.05)。动脉灌注NACT组手术时间短于直接手术组,术中血量要少于直接手术组(P<0.05)。淋巴结转移率动脉灌注NACT组为16.15%,直接手术组为29.85%,差异有统计学意义(P<0.05);深肌层浸润率和宫旁浸润率两组差异均不明显(P>0.05)。[结论]宫颈癌手术前进行动脉灌注NACT可缩短手术所需时间,进而减少手术过程中的出血量,降低淋巴结转移率,最终提高疗效。
[Objective] To evaluate the value of neoadjuvant chemotherapy (NACT) for the treatment of cervical cancer. [Method] 87 patients with stage Ⅰb2 ~ Ⅱb cervical cancer were randomly divided into direct operation group (n = 43) and arterial infusion NACT group (n = 44). The changes of tumor size and adverse reactions in arterial perfusion NACT group before and after treatment were observed. The operation time, blood loss during operation and postoperative pathological features were compared. [Results] The effective rate of chemotherapy in patients with NACT was CR9 and PR22, with an effective rate of 70.45%. There was no correlation between the effective rate of chemotherapy and the age, stage and differentiation degree of the patients, but related to the pathological type and tumor size (P <0.05). Arterial infusion of NACT group shorter operative time than direct surgery group, less blood volume during surgery than direct surgery group (P <0.05). The rate of lymph node metastasis was 16.15% in NACT group and 29.85% in direct operation group (P <0.05). There was no significant difference between deep muscular layer invasion rate and uterine infiltration rate (P> 0.05) . [Conclusion] Arterial infusion of NACT before cervical cancer surgery can shorten the time required for surgery, thereby reducing the amount of bleeding during operation, reducing the rate of lymph node metastasis and ultimately improving the curative effect.