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目的探讨新辅助化学疗法(化疗)对Ⅰ_(B2)~Ⅱ_B期宫颈癌的疗效及安全性。方法选取2012年6月—2014年12月收治的66例Ⅰ_(B2)~Ⅱ_B期宫颈癌患者,给予PT(顺铂/卡铂+紫杉醇/多西他赛)方案化疗,评估疗效显著者行手术治疗,并观察化疗后肿瘤消退情况、化疗的毒副反应等。结果新辅助化疗肿瘤消退情况:完全缓解10.6%(7/66),部分缓解59.1%(39/66),总有效率69.7%。常见不良反应为骨髓抑制59.1%(39/66)和消化道反应33.3%(22/66),经积极防治均可耐受或较满意缓解。宫颈鳞状细胞癌、腺癌、腺鳞癌化疗的有效率分别为72.6%、33.3%、0%;高、中、低分化宫颈癌化疗的有效率分别为100.0%、77.3%、55.9%,差异均有统计学意义(P<0.05)。结论新辅助化疗是治疗局部晚期宫颈癌的一种安全有效的辅助治疗手段;因样本例数有限,新辅助化疗疗效与肿瘤分化程度和病理类型的相关性仍需临床进一步探讨。
Objective To investigate the efficacy and safety of neoadjuvant chemotherapy (chemotherapy) on cervical cancer Ⅰ_ (B2) ~ Ⅱ_B. Methods Sixty-six patients with stage Ⅰ B2, stage Ⅱ B cervical cancer admitted from June 2012 to December 2014 were enrolled in this study. Patients with PT (cisplatin / carboplatin + paclitaxel / docetaxel) Surgical treatment and observation of tumor regression after chemotherapy, chemotherapy side effects. Results Neoadjuvant chemotherapy tumor regression: complete remission 10.6% (7/66), partial remission 59.1% (39/66), the total effective rate 69.7%. Common adverse reactions were 59.1% (39/66) of myelosuppression and 33.3% (22/66) of gastrointestinal reactions, which could be tolerated or more satisfactorily relieved after active prevention and treatment. The effective rates of chemotherapy for cervical squamous cell carcinoma, adenocarcinoma and adenosquamous carcinoma were 72.6%, 33.3% and 0% respectively. The effective rates of chemotherapy for high, moderate and poorly differentiated cervical cancer were 100.0%, 77.3% and 55.9%, respectively, The differences were statistically significant (P <0.05). Conclusions Neoadjuvant chemotherapy is a safe and effective adjuvant therapy for locally advanced cervical cancer. Due to the limited number of cases, the relationship between neoadjuvant chemotherapy efficacy and tumor differentiation and pathological type remains to be further explored.