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目的探讨新辅助化疗治疗局部晚期宫颈癌的临床疗效。方法选取2008年1月至2011年1月间收治的局部晚期宫颈癌患者56例,按随机数字法分为观察组(术前新辅助化疗+根治术)和对照组(宫颈癌根治术),每组28例。平均随访3年,观察并比较两组患者手术时间、术中出血量、术后淋巴结转移率、近期疗效及远期生存率。结果观察组患者的手术时间为(3.1±0.5)h,术中出血量为(560±200)ml,术后宫旁淋巴结转移率为3.6%,盆腔淋巴结转移率为7.1%,治疗总有效率为57.1%,术后3年生存率为64.3%。对照组患者手术时间为(4.5±0.8)h,术中出血量为(820±250)ml,术后宫旁淋巴结转移率为21.4%,盆腔淋巴结转移率为28.6%,治疗总有效率为28.6%,术后3年生存率为35.7%。两组相比,差异均有统计学意义(均P<0.05)。结论术前新辅助化疗能够明显提高局部晚期宫颈癌的近期疗效和远期生存率,改善患者的生活质量,值得在临床推广应用。
Objective To investigate the clinical effect of neoadjuvant chemotherapy in the treatment of locally advanced cervical cancer. Methods Fifty-six patients with locally advanced cervical cancer who were admitted between January 2008 and January 2011 were randomly divided into observation group (neoadjuvant chemotherapy + radical operation) and control group (radical cervical cancer) 28 cases in each group. After a mean follow-up of 3 years, the operation time, intraoperative blood loss, postoperative lymph node metastasis, short-term efficacy and long-term survival were observed and compared. Results The operation time of observation group was (3.1 ± 0.5) h, blood loss was (560 ± 200) ml, postoperative parathyroid lymph node metastasis rate was 3.6% and pelvic lymph node metastasis rate was 7.1%. The total effective rate For 57.1%, 3-year survival rate was 64.3%. The operation time of the control group was (4.5 ± 0.8) h, the blood loss was (820 ± 250) ml, the para-lymph node metastasis rate was 21.4%, the pelvic lymph node metastasis rate was 28.6% and the total effective rate was 28.6 %, 3-year survival rate was 35.7%. The differences between the two groups were statistically significant (both P <0.05). Conclusions Neoadjuvant chemotherapy before operation can significantly improve the short-term curative effect and long-term survival rate of locally advanced cervical cancer and improve the quality of life of patients. It is worthy of clinical application.