摘要
目的比较不同途径新辅助化疗对Ⅰb2～Ⅱb期宫颈癌的疗效。方法对北京协和医院1999年以来收治的147例Ⅰb2～Ⅱb期行新辅助化疗的宫颈癌患者的临床病理资料进行回顾性分析，其中，经静脉全身化疗者（静脉组）52例，经子宫动脉插管化疗者（动脉组）95例。结果静脉组患者经新辅助化疗后总反应率为88％（46／52），动脉组为79％（75／95），两组比较，差异无统计学意义（P〉0．05）。静脉组患者新辅助化疗后可手术率为81％（42／52），动脉组为72％（68／95），两组比较，差异无统计学意义（P〉0．05）。两组患者新辅助化疗后手术时间、出血量和并发症发生率相近。Ⅱb期患者经新辅助化疗后手术，术后病理检查发现宫旁仍有肿瘤浸润者动脉组显著低于静脉组（分别为6％、50％，P〈0．05）。静脉组和动脉组患者治疗后复发率（分别为13％、17％）和死亡率（分别为9％、12％，P〉0．05）分别比较，差异均无统计学意义（P〉0．05）。结论两种途径的新辅助化疗后反应率、可手术率及手术难度相当；子宫动脉介入化疗对改善宫旁浸润效果更好。
Objective To compare the effect between intra-arterial and intra-venous neoadjuvant chemotherapy （NACT） in stage Ⅰ b2 - Ⅱ b cervical carcinoma. Methods A retrospective analysis was done on 52 cases of intra-venous NACT and 95 cases of intra-arterial NACT for stage Ⅰ b2 - Ⅱ b cervical carcinoma treated in Peking Union Medical College Hospital from 1999. Results The response rate of intra- venous NACT and intra-arterial NACT was 88% （46/52） and 79% （75/95）, and the operative rate after NACT was 81% （42/52） and 72% （68/95） respectively （ P 〉 0. 05 ）. There were no significant differences in surgery time, blood loss and post-operative morbidity between these two groups. Pathological parametrial positive rate after NACT in arterial group （6%） was significantly lower than that of venous group （50%, P 〉0. 05）. The venous group had very similar recurrence rates （13% vs 17% ） and death rates （9% vs 12% ） when compared with the arterial group （P 〉 0. 05 ）. Conclusions The intra-arterial and intra-venous NACT for stage Ⅰ b2 - Ⅱ b cervical carcinoma show similar response rate, operative rate and surgical difficulties. Arterial NACT shows a better effect on parametrial infiltration.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2008年第12期888-891,共4页
Chinese Journal of Obstetrics and Gynecology
