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目的:探讨PVM新辅助化疗(NACT)方案治疗局部晚期宫颈癌的近期疗效及其对预后的影响。方法:分析46例局部晚期宫颈癌患者行PVM方案新辅助化疗的近期疗效,影响疗效的因素以及术后生存情况。选取23例宫颈癌活检和术后标本进行Ki67和Bax测定。结果:临床总有效率为82.61%,其中2例完全缓解,36例部分缓解,8例稳定。化疗近期疗效与肿瘤体积显著相关(P<0.05)。化疗有效组和无效组患者的平均无瘤生存期为48.9个月和13.7个月(P<0.05)。化疗有反应者NACT后Ki67表达显著降低,Bax表达显著升高(P<0.05);无反应者NACT前后Ki67、Bax表达无统计学差异(P>0.05)。NACT前Ki67着色指数大于33%和小于33%的患者平均无瘤生存期分别为48.6个月和19个月(P<0.05)。结论:PVM方案总体有效率高,使原来无法手术的患者有可能获得手术机会。Ki67、Bax与化疗疗效显著相关,化疗近期疗效仅与肿瘤体积有关。
Objective: To investigate the short-term curative effect of PVM neoadjuvant chemotherapy (NACT) on locally advanced cervical cancer and its effect on prognosis. Methods: 46 cases of locally advanced cervical cancer patients underwent PVM regimen neoadjuvant chemotherapy in the short term efficacy, factors that affect the efficacy and postoperative survival. 23 cases of cervical cancer biopsy and postoperative specimens for Ki67 and Bax determination. Results: The total clinical effective rate was 82.61%, of which 2 cases were completely relieved, 36 cases partially relieved and 8 cases stable. The recent curative effect of chemotherapy was significantly correlated with tumor volume (P <0.05). The mean tumor-free survival of patients in the chemotherapy and ineffective groups was 48.9 months and 13.7 months, respectively (P <0.05). The Ki67 expression was significantly decreased and the expression of Bax was significantly increased after NACT (P <0.05). There was no significant difference in the expression of Ki67 and Bax before and after NACT (P> 0.05). The mean tumor-free survival for patients with NACT pre-Ki67 staining greater than 33% and less than 33% were 48.6 months and 19 months, respectively (P <0.05). Conclusion: The overall effective rate of PVM regimen is high, which makes it possible for the original inoperable patients to obtain the chance of operation. Ki67, Bax and chemotherapy were significantly related to the efficacy of chemotherapy in the near future only with tumor volume.