Ⅰb-Ⅱa期巨块型宫颈癌术前介入化疗及放疗近期疗效对比分析.docVIP

Ⅰb-Ⅱa期巨块型宫颈癌术前介入化疗及放疗近期疗效对比分析 　 作者：肖勇，黄凤英，王革，姚招琴 【关键词】 宫颈肿瘤 　　［摘要］ 目的：探讨术前介入化疗与放疗治疗Ⅰb-Ⅱa期巨块型宫颈癌的的近期疗效和价值。方法：对73例Ⅰb-Ⅱa期巨块型宫颈癌患者分组进行盆腔介入化疗与放疗，化疗组以卡铂300 mg/m2、平阳霉素50 mg/m2、长春新碱1 mg/m2进行介入治疗；放疗组采用腔内后装治疗，每周一次，每次A点剂量6 Gy~7 Gy，A点总剂量20 Gy~30 Gy。经治疗后3周进行宫颈癌根治术。结果:术前介入治疗组比放疗组肿瘤退缩明显，总有效率(CR+PR)%分别为89.5%和71.4%，差异有显著性(P＜0.05)；介入化疗组与放疗组的淋巴结转移率分别为15.8%和17.1%，差异无显著性(P＞0.05)。结论：Ⅰb-Ⅱa期巨块型宫颈癌患者术前行盆腔介入化疗近期疗效好于术前放疗者。 　　［关键词］ 宫颈肿瘤；介入性化疗；放射治疗；根治术；疗效 　　Curative Effect of Intraarterial Neoadjucant Chemotherapy and Radiotherapy Before Radical Hysterectomy for 73 Cases with Massive Cervical Cancer in StageⅠb-Ⅱa 　　Abstract：Objective: To study the curative effect of intraarterial chemotherapy and radiotherapy before radical excision for patients with massive cervical cancer in stage Ⅰb-Ⅱa. Methods 38 cases with massive cervical cancer in stageⅠb-Ⅱa were treated with a course of bilateral internal iliactery infusion of carboplatin 300mg/m2、doxorubicin 50 mg/m2 and vincristine 1 mg/m2 before radical hysterectomy.while the others were treated with middledoserate afterloading technigue in the radiatinon treatment(1times/week,6 Gy~7 Gy in A point/time,total dose was 20 Gy~30 Gy in A point.Results Patients treated with intraarterial chemotherapy achieved more significant effect than the others treated with radiotherapy (P＜0.05). The rate of pelvic lymphnode metastasis between two groups has no significant effect.(P＞0.05). Conclusion The patients treated with intra-arterial chemotherapy will get better curative effect than the others treated with radiotherapy. 　　Key words： Cervical neoplasm; Intraarterial chemotherapy; Radiotherapy; Radical hysterectomy; Therapeutic effect 　　Ⅰb-Ⅱa期巨块型宫颈癌由于术后复发和转移率高，采用综合治疗可缩小肿瘤体积，提高手术切净率，减少术后复发和转移。以往常用术前放疗，随着新辅助化疗概念的提出，宫颈癌的化疗越来越受到重视，其中术前介入化疗是一种较先进的方式。本文通过对73例Ⅰb-Ⅱa期巨块型宫颈癌术前分组进行盆腔介入化疗与放疗，对比其临床资料，探讨两者的近期疗效，总结如下。 　　1 材料和方法 　　1.1 一般资料 我院自1998年1月至2005年8月间共收治Ⅰb-Ⅱa期巨块型宫颈癌患者73例。年龄24岁~68岁，平均46.5岁。经阴道镜下活检病理确诊为宫颈癌，其中高分化鳞癌34例；中分化鳞癌18例；低分化鳞癌21例(腺癌放疗疗效与鳞癌相差较大、例数少，为增加两组病人之间可比性，予选择性删