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目的:比较ⅠB2期和巨块型ⅡA期宫颈癌术前放化疗和新辅助化疗的疗效。方法:2003-03-2006-03收治ⅠB2期和巨块型ⅡA期的宫颈癌患者83例,分为术前放化疗组和新辅助化疗组,放化疗组术前予盆腔外照射40Gy同期静脉PF方案化疗2个周期,新辅助化疗组方案剂量与放化疗组相同,平均2个周期。2～4周后接受宫颈癌根治术,术前治疗结束后2周评价近期临床缓解率。结果:放化疗组临床完全缓解率、部分缓解率分别为39.5%和55.8%,新辅助化疗组分别为32.5%和35.0%,P值分别为0.505和0.057。宫颈病理完全缓解率放化疗组48.8%,新辅助化疗组27.5%,P=0.046;5年无复发生存率放化疗组优于新辅助化疗组(P=0.039),5年生存率两组差异有统计学意义,P=0.048。严重的不良反应(Ⅲ、Ⅳ级)两组比较差异无统计学意义。结论:术前放化疗比单一的术前新辅助化疗更能降低宫颈肿瘤残存率,提高宫颈病理完全缓解率,并能提高5年生存率及无复发生存率。
Objective: To compare the efficacy of preoperative chemoradiotherapy and neoadjuvant chemotherapy for stage ⅠB2 and massive ⅡA cervical cancer. Methods: 83 cases of cervical cancer who underwent stage ⅠB2 and giant-block Ⅱ A from 2003-03-2006-03 were divided into preoperative chemoradiation group and neoadjuvant chemotherapy group. The radiotherapy and chemotherapy group received preoperative pelvic extracorporeal radiation (40Gy) PF regimen 2 cycles of chemotherapy, neoadjuvant chemotherapy dose and radiotherapy and chemotherapy group the same dose, an average of 2 cycles. 2 to 4 weeks after radical surgery for cervical cancer, preoperative evaluation of 2 weeks after the end of clinical remission rate. Results: The rates of complete remission and partial remission in radiotherapy and chemotherapy group were 39.5% and 55.8%, respectively, while those in neoadjuvant chemotherapy group were 32.5% and 35.0%, respectively. The P values were 0.505 and 0.057 respectively. Cervical pathology complete remission rate of radiotherapy and chemotherapy group 48.8%, neoadjuvant chemotherapy group 27.5%, P = 0.046; 5-year recurrence-free survival rate of radiotherapy and chemotherapy group than neoadjuvant chemotherapy group (P = 0.039), 5-year survival rate difference between the two groups There was statistical significance, P = 0.048. Serious adverse reactions (Ⅲ, Ⅳ grade) were no significant difference between the two groups. Conclusion: Preoperative chemoradiotherapy can reduce the residual rate of cervical cancer more than single neoadjuvant chemotherapy, improve the complete remission rate of cervical pathology, and improve the 5-year survival rate and recurrence-free survival rate.