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目的评价早期巨块型宫颈癌患者术前行新辅助化学疗法的近期疗效。方法回顾分析2005年10月2010年6月收治的Ⅰb~Ⅱa期巨块型宫颈癌患者90例患者的临床资料。根据术前是否行化学疗法将患者分为两组:新辅助化学疗法(neoadjuvant chemotherapy,NACT)组50例,术前予静脉化学疗法或子宫动脉灌注化学疗法治疗1~3个疗程;直接手术组40例,直接行根治性手术。比较新辅助化学疗法前后病灶大小变化,化学疗法不良反应,手术情况及术后病理情况。结果 NACT组总有效率86%(43/50),鳞癌疗效优于腺癌,动脉与静脉化学疗法近期有效率比较,两组差异无统计学意义(P>0.05)。NACT不良反应小。NACT组术中出血少于直接手术组,两者差异有统计学意义(P<0.05)。两组深肌层浸润、淋巴结转移、脉管浸润差异均无统计学意义(P>0.05),NACT组宫旁浸润率低于直接手术组。结论术前NACT对早期巨块型宫颈癌患者近期疗效显著。
Objective To evaluate the short-term effect of neoadjuvant chemotherapy in patients with early giant cervical carcinoma. Methods The clinical data of 90 patients with massive type Ⅰb ~ Ⅱa cervical cancer who were admitted to our hospital from October 2005 to June 2010 were retrospectively analyzed. Patients were divided into two groups according to whether chemotherapy was performed preoperatively: 50 patients in neoadjuvant chemotherapy (NACT group), 1 to 3 courses of preoperative chemotherapy or uterine arterial infusion chemotherapy, 40 cases, direct radical surgery. Comparison of neoadjuvant chemotherapy before and after the size of lesions, adverse reactions to chemotherapy, surgery and postoperative pathology. Results The total effective rate of NACT group was 86% (43/50). The efficacy of squamous cell carcinoma was better than that of adenocarcinoma. There was no significant difference between the two groups in the short term effective rate of arterial and venous chemotherapy (P> 0.05). NACT adverse reactions small. The NACT group had less intraoperative bleeding than the direct operation group, the difference was statistically significant (P <0.05). There was no significant difference in deep myometrial invasion, lymph node metastasis and vascular invasion between the two groups (P> 0.05). The infiltration rate of uterus in NACT group was lower than that in direct operation group. Conclusion Preoperative NACT has significant curative effect on patients with early massive cervical cancer.