术前新辅助化疗在Ⅰb2～Ⅱb期子宫颈腺癌中的应用效果观察
Effect of preoperative neoadjuvant chemotherapy on the patients with stageⅠb2 to Ⅱb cervical adenocarcinoma
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摘要: 目的：探讨新辅助化疗治疗Ⅰb2～Ⅱb期子宫颈腺癌的近期疗效。方法：将Ⅰb2～Ⅱb期子宫颈腺癌患者44例随机分为2组：对照组20例采用单纯手术治疗；研究组24例采用紫杉醇联合顺铂或奈达铂化疗1～2个疗程后行广泛性全子宫双附件切除+盆腔淋巴结清扫术。观察患者化疗前后的肿瘤变化情况及2组患者的术后淋巴结转移、宫旁脉管癌栓、宫颈浸润、出血量、手术时间情况及不良反应。结果：新辅助化疗能够使肿瘤体积较化疗前缩小或消失，临床有效率高达70.8%。研究组和对照组患者的手术时间分别为（180±30）min和（200±30）min，术中出血量分别为（400±50）ml和（450±50）ml，研究组均少于对照组（P<0.05和P<0.01）。研究组和对照组宫颈深层间质浸润发生率分别为37.5%和 70.0%，脉管癌栓发生率分别为25.0%和55.5%，淋巴结转移率分别为12.5%和40.0%，研究组均低于对照组（P<0.05），而2组阴道切缘率分别为0.00%和15.0%，差异无统计学意义（P>0.05）。结论：术前新辅助化疗可以提高手术治疗Ⅰb2～Ⅱb期子宫颈腺癌的临床疗效。Abstract: Objective: To explore the curative effects of neoadjuvant chemotherapy on stageⅠb2 to Ⅱb cervical adenocarcinoma.Methods: Forty-four patients with stageⅠb2 to Ⅱb cervical adenocarcinoma were randomly divided into the observation group(24 cases) and control group(20 cases).The control group were treated with radical surgery only,the observation group were treated with the whole uterus and double accessories resection combined with pelvic lymph node dissection after the chemotherapy of paclitaxel combined with cisplatin or nedaplatin for 1 to 2 courses.The tumor change in observation group was observed after chemotherapy.The lymphatic metastasis,intravascular cancer emboli,cervical infiltration,amount of bleeding,operation time and adverse reactions in two groups were compared.Results: The tumor shrank or disappeared after neoadjuvant chemotherapy,the clinical efficiency of which was 70.8%.The operation time of the observation group and control group were(180±30)min and(200±30)min,respectively,the amount of bleeding during operation of the observation group and control group were(400±50)ml and(450±50)ml,respectively.The operation time and amount of bleeding during operation in observation group were less than those in control group(P<0.05 and P<0.01).The occurrence rates of cervical deep stromal infiltration,intravascular cancer emboli and lymphatic metastasis in observation group and control group were 37.5% & 70.0%,25.0% & 55.5% and 12.5% & 40.0%,respectively,these data in observation group were lower than those in control group(P<0.05).The resection rates of vaginal margin in observation group and control group were 0.0% and 15.0 %,respectively,the difference of which was not statistically significant(P>0.05).Conclusions: Neoadjuvant chemotherapy can improve the clinical effects of surgery on stageⅠb2 to Ⅱb cervical adenocarcinoma.
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Key words:
- cervical adenocarcinoma /
- neoadjuvant chemotherapy /
- clinical efficacy
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