摘要
【目的】探讨新辅助化疗在早期宫颈癌术前治疗中的疗效。【方法】收集本院2000年3月至2004年11月收入院的33例早期宫颈癌(Ⅰb1期～Ⅰa期),经腹壁下动脉插管后,髂内动脉灌注化疗,药物以顺铂为主的联合方案,所有病人均完成2个疗程化疗,化疗结束后14d经妇科检查,B超测量宫颈肿块消退情况,按UICC疗效标准评价疗效。化疗结束后2周行子宫广泛切除加盆腔淋巴结清扫。【结果】化疗总有效率87.9%,CR57.6%,PR30.3%,SD9.0%,PD3.0%,其中Ⅰb1期全组有效率100%,Ⅰb2期90.0%,Ⅱa期71.4%,鳞癌86.7%,腺癌100%;宫颈肿块<4cm有效率92.3%,≥4cm85.0%。术后病理检查阳性结果。宫颈残留Ⅰb1期33.3%,Ⅰb2期60.0%,Ⅱa期42.8%,宫旁浸润Ⅰb2期5.0%,Ⅱa期14.2%。盆腔淋巴转移Ⅰb2期15.0%,Ⅱa期14.2%,宫颈肿块<4cm7.6%,≥4cm15.0%。术后无一例膀胱输尿管瘘,随访1～3年2例死于复发癌,复发率6.0%。【结论】新辅助化疗作为早期宫颈癌术前治疗,可以明显缩小和消退宫颈肿块,减少术后宫旁浸润,淋巴结转移,降低术后并发症,减少术后复发。
[Objective]To investigate the effect of neoadjuvant chemptherapy （NACT） in early carcinoma of cervix. [Methods]Thirty three patients with stage Ⅰ a to stage Ⅱ a cervical carcinoma received NACT for 2 periods of treatment before operation. The evaluation was made according to UICC on 14 days after NACT, Then the hysterectomy was done. [Results]The total efficient rate of NACT was 87%, CR 57%, PR 30%, SD 9.0%, PD 3.0%. The efficient rates of NACT of stage Ⅰ b1 , Ⅰ b2 , Ⅱa squamous carcinoma, adenocarcinoma, patients with node of tumor .〈 and 〉 4 cm were 100%, 90.0%,71.4% ,86.7% ,100% ,92.3% and 85. 0% respectively. By evaluating the state of illness after operation, the efficient rates of stage Ⅱ b1, Ⅰ b2, Ⅱa, Ⅱ b, patients with lymph node metastasis, patients with node of tumor 〈 and 〉 4 cm were 33.3 %, 60.0 %, 42.8%, 5.0%, 14.2%, 7.6% and 15.0%, respectively. No vesical fistula was found after operation. The recurrence rate was 6.0% （only 2 cases developed recurrence 3 years after operation）. [Conclusion]As a kind of therapy used in early cervical carcinoma before operation, NACT can shrink significantly the cervical tumor, reduce invasion and metastasis, decrease complications and the pelvic recurrence after operation.
出处
《医学临床研究》
CAS
2006年第3期380-382,共3页
Journal of Clinical Research
