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目的:探讨新辅助化疗(NACT)在宫颈癌治疗中的近期临床疗效及临床应用价值。方法:选择初治局部晚期宫颈癌37例,其中ⅠB2期3例,ⅡA期20例,ⅡB期14例;鳞癌33例,腺癌2例,腺鳞癌1例,神经内分泌癌1例。术前采用紫杉醇联合卡铂化疗1~3个疗程,观察近期疗效。结果:本研究新辅助化疗的近期总有效率(完全缓解与部分缓解之和)为56.76%;新辅助化疗后34例患者行手术治疗,手术切除率91.89%;术后手术病理分期降级者17例,术后病理证实淋巴结转移阳性者10例,宫旁浸润者4例。其中34例患者经1~3个疗程化疗后行宫颈癌根治术。3例ⅡB期行2个疗程化疗后因手术困难,给予同步放化疗,其中2例患者肿瘤稳定,1例肿瘤进展。所有患者阴道流血、排液及疼痛均有不同程度好转。结论:新辅助化疗对局部晚期宫颈癌能有效缩小病灶体积,提高手术切除率,并提高年轻患者的生活质量。
Objective: To investigate the recent clinical efficacy and clinical value of neoadjuvant chemotherapy (NACT) in the treatment of cervical cancer. Methods: Thirty-seven patients with locally advanced cervical cancer were selected. Among them, there were 3 cases of stage ⅠB2, 20 cases of stage ⅡA and 14 cases of stage ⅡB; 33 cases of squamous cell carcinoma, 2 cases of adenocarcinoma, 1 case of adenosquamous carcinoma and 1 case of neuroendocrine carcinoma. Preoperative use of paclitaxel combined carboplatin chemotherapy 1 to 3 courses to observe the short-term effect. Results: The total effective rate (complete remission and partial remission) of neoadjuvant chemotherapy in this study was 56.76%. Surgical treatment was performed in 34 patients after neoadjuvant chemotherapy, and the surgical resection rate was 91.89%. The postoperative surgical pathological stage was degraded by 17 Cases, postoperative pathology confirmed lymph node metastasis in 10 cases, 4 cases of uterine infiltration. Among them, 34 patients underwent radical mastectomy for cervical cancer after 1 to 3 courses of chemotherapy. 3 cases of Ⅱ B period after 2 courses of chemotherapy due to surgical difficulties, given concurrent chemoradiotherapy, including 2 patients with stable tumor, 1 case of tumor progression. All patients with vaginal bleeding, drainage and pain are improved to varying degrees. Conclusion: Neoadjuvant chemotherapy for locally advanced cervical cancer can effectively reduce the volume of lesions, improve the surgical resection rate, and improve the quality of life of young patients.