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[目的]研究术前新辅助化疗对Ⅰb2~Ⅱb期局部晚期宫颈癌的临床疗效。[方法]Ⅰb2~Ⅱb期局部晚期宫颈癌患者280例,依据治疗方法的不同分为两组,对照组直接进行手术,研究组在术前采取新辅助化疗。再依据化疗方案的不同将研究组分为TP组和PVB组。研究组患者分别在化疗前和每个疗程结束后进行妇科检查及影像学检测宫旁改变情况和病灶大小;观察术后患者的病理情况;比较TP组和PVB组消化系统、造血系统和肝肾功能的不良反应发生率。[结果 ]研究组与对照组术中出血量和手术时间无明显差异(P>0.05),研究组的阴道、宫旁切缘阳性率和脉管、淋巴转移率均明显低于对照组(P<0.05);TP组和PVB组的阴道、宫旁切缘阳性率和脉管、淋巴转移率相比无明显差异(P>0.05);TP组和PVB组消化系统、造血系统和肝肾功能的不良反应发生率相比均无明显差异(P>0.05);研究组治疗后临床分期较治疗前均明显降低(P<0.05)。[结论]术前新辅助化疗能缩小Ⅰb2~Ⅱb期局部晚期宫颈癌患者的病灶大小并改善预后,TP与PVB两种化疗方案在缩小局部肿瘤、减少用药不良反应及改善患者预后方面的效果相似。
[Objective] To study the clinical effect of preoperative neoadjuvant chemotherapy on stage Ⅰb2 ~ Ⅱb locally advanced cervical cancer. [Methods] A total of 280 patients with stage Ⅱb2 ~ Ⅱb advanced cervical cancer were divided into two groups according to the different treatment methods. The control group received direct operation and the study group received neoadjuvant chemotherapy before operation. According to different chemotherapy regimens, the study group was divided into TP group and PVB group. Patients in the study group were treated with gynecological examination and imaging examination before and after the completion of each course. The changes of the uterus and the size of the lesions were observed. The pathological changes of the patients were observed. The digestive system, hematopoietic system, Function adverse reaction rate. [Result] There was no significant difference between operation group and control group (P> 0.05). The positive rate of vaginal and palatoporal margins and the rate of vessel and lymph node metastasis in study group were significantly lower than those in control group (P <0.05). There was no significant difference in the positive rates of vaginal and paracancerous margins between the TP group and the PVB group (P> 0.05). The digestive system, hematopoietic system and liver-kidney function of TP group and PVB group (P> 0.05). The clinical stage of study group after treatment was significantly lower than that before treatment (P <0.05). [Conclusion] Preoperative neoadjuvant chemotherapy can reduce the lesion size and improve the prognosis of stage Ⅰb2 ~ Ⅱb patients with locally advanced cervical cancer. The two chemotherapy regimens of TP and PVB are similar in reducing local tumor, reducing adverse drug reactions and improving the prognosis of patients .