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目的:探讨Ⅰa2-Ⅰb1期仅有低分化高危因素宫颈鳞癌患者的治疗模式。方法:采用前瞻性随机对照研究的分析方法,将该院2007年1月~2012年12月收治的Ⅰa2-Ⅰb1期仅有低分化高危因素的宫颈鳞癌患者60例,分为单纯手术组(对照组)和手术+术后化疗组(观察组),总结所有患者手术并发症和观察组患者的化疗毒副反应。同时对两组间的复发率、3年累积无瘤生存率进行比较。结果:所有患者手术并发症的总发生率为33.33%(20/60),观察组主要的毒副反应发生率为骨髓抑制16.67%(5/30),胃肠道反应23.33%(7/30),肝肾功能损害3.33%(1/30);对照组和观察组的复发率分别为6.67%和0.00%,差异无统计学意义(P>0.05);3年累积无瘤生存分别为91.83%和100.00%,差异无统计学意义(P>0.05)。结论:手术+术后化疗对于仅有低分化高危因素的Ⅰa2-Ⅰb1期宫颈鳞癌患者是一种可行的治疗选择,患者可耐受手术联合单纯化疗的并发症和毒副反应,并获得较好的近远期疗效。
Objective: To investigate the treatment of cervical squamous cell carcinoma in patients with Ⅰa2-Ⅰb1 stage only with poorly differentiated risk. Methods: A prospective randomized controlled study was performed in 60 patients with cervical squamous cell carcinoma of low grade Ⅰa2-Ⅰb1 who were admitted to our hospital from January 2007 to December 2012. The patients were divided into simple operation group Control group) and operation + postoperative chemotherapy group (observation group). All the patients were divided into two groups: operation complications and observation group. At the same time the relapse rate between the two groups, 3-year cumulative tumor-free survival rates were compared. Results: The overall incidence of surgical complications in all patients was 33.33% (20/60). The incidence of major adverse reactions in the observation group was 16.67% (5/30) in myelosuppression and 23.33% (7/30) in gastrointestinal tract ), And liver and kidney dysfunction was 3.33% (1/30). The recurrence rates of the control group and the observation group were 6.67% and 0.00% respectively, with no significant difference (P> 0.05). The 3-year cumulative tumor-free survival was 91.83 % And 100.00%, respectively, with no significant difference (P> 0.05). Conclusions: Surgical plus postoperative chemotherapy is a feasible treatment for patients with stage Ⅰ 2a-1b cervical cancer who have only poorly differentiated risk factors. Patients can tolerate the complications and adverse reactions of surgery combined with chemotherapy alone, Good near and long-term effect.