局部晚期宫颈癌术前新辅助化疗近期治疗结局评价.docVIP

局部晚期宫颈癌术前新辅助化疗近期治疗结局评价 　　摘要：目的 评价局部晚期宫颈癌术前新辅助化疗（NACT）的近期疗效并探讨其对临床病理特征的影响。方法 以2010年2月～2014年7月贵州省人民医院收治的168例IB-IIB期宫颈癌初治患者为研究对象进行回顾性非随机对照研究，根据是否行术前新辅助化疗分为研究组（NACT+S组）45例和对照组（S组）123例。以RECIST1.1为标准评价新辅助化疗的近期疗效，然后收集两组的手术时间、术中出血量及多项临床病理特征结果进行比较研究。结果 两组的年龄、病理类型构成及手术方式等基线指标相当，具可比性。NACT+S组患者新辅助化疗的临床总有效率为73.33%（33/45），均为部分?解（PR）。NACT+S组的平均手术时间和术中出血量与S组相比差异无统计学意义（P0.05）。NACT+S组中IIB期患者比例（44.44%）明显高于S组（7.32%），然而其中-低/低分化病例所占的比例（24.44%）明显低于S组（45.53%），且深间质浸润（64.44% vs 81.30%）、宫旁浸润（6.67% vs 20.33%）、神经侵犯/脉管癌栓（22.22% vs 39.84%）、阴道残端/壁切缘阳性（6.67% vs 20.33%）、盆腔淋巴结转移（22.22% vs 40.65%）的发生率均显著低于S组。结论 局部晚期宫颈癌患者术前行新辅助化疗后大部分可获得部分缓解的疗效，并可降低深间质浸润、宫旁浸润、神经侵犯/脉管癌栓、切缘阳性、盆腔淋巴结转移的发生率。 　　关键词：宫颈癌；新辅助化疗；临床病理特征 　　中图分类号：R737.33 文献标识码：A 文章编号：1006-1959（2017）13-0059-04 　　Abstract：Objective To evaluate the short-term efficacy of neoadjuvant chemotherapy（NACT）in locally advanced cervical cancer and to explore its effect on clinicopathological features.Methods 168 patients with stage IB-IIB cervical cancer in February 2010～July 2014 in Guizhou Peoples Hospital were initially treated as a research object of retrospective non randomized studies，according to whether the preoperative neoadjuvant chemotherapy were divided into study group（NACT+S group）45 cases and control group（S group）123 cases.The recent curative effect evaluation based on RECIST1.1 standard neoadjuvant chemotherapy，and then collected the operation time of the two groups，the amount of intraoperative bleeding and other clinical and pathological features were compared between two groups.Results The age，pathological type and surgical approach of the two groups were comparable and comparable.The total effective rate of neoadjuvant chemotherapy in patients with NACT+S group was 73.33%（33/45），which was partial remission（PR）.There was no significant difference in the average operation time and intraoperative blood loss between the NACT+S group and the S group（P0.05）.The percentage of patients with stage IIB in the NACT+S group（44.44%）was significantl