新辅助化疗在局部晚期宫颈癌治疗中的疗效观察

目的：探讨新辅助化疗联合手术治疗较传统手术治疗Ib2、IIa2局部晚期宫颈癌的临床疗效。方法：选取2008年6月～2011年12月在黑龙江省哈尔滨医科大学附属第三医院初治宫颈癌患者120例,临床分期为Ib2期、IIa2期,术前均经病理证实为宫颈鳞癌,将其分为两组：研究组（新辅助化疗联合手术治疗组）;对照组（单纯手术治疗组）。研究组给予1～2个疗程的新辅助化疗后评估其化疗疗效,有效者化疗结束后行广泛性子宫切除＋盆腔淋巴结清扫术;对照组直接行手术治疗。结果：新辅助化疗能够使肿瘤体积较化疗前缩小或消失,临床有效率高达81.43%,从而降低了宫颈癌的临床分期,提高手术的切除率,扩大手术适应征,降低术后病理高危因素,同时手术治疗能保留卵巢功能,提高年轻宫颈癌患者生活质量。结论：术前新辅助化疗可以提高手术治疗局部晚期宫颈癌的临床疗效。

Clinical Observation of Neoadjuvant Chemotherapy in Locally Advanced Cervical Cancer

Objective： To investigate the clinical efficacy of neoadjuvant chemotherapy in the Ib2-IIa cervical cancer. Methods： 120 cases of locally advanced cervical cancer at the stage Ib2-IIa before surgery who were admitted in the Third Affiliated Hospital of Harbin Medical University, Heilongjiang Province from June 2008 to December 2011 were selected and randomly divided into two groups： study group（neoadjuvant chemotherapy and surgery group） and control group（direct surgery group）. Patients in study group were treated with 1 -2 cycles of neoadjuvant chemotherapy to assess the efficacy of chemotherapy, effective cases by the end of chemotherapy underwent radical hysterectomy and pelvic lymph node dissection; patients in control group underwent surgery. Results： Neoadjuvant chemotherapy can make the volume of the tumor with chemotherapy prior to shrink or disappear, clinical efficiency up to 81.43%, so that can reduce the cervical cancer clinical staging operation, improve the resection rate, enlarge the indication of operation, and reduce the postoperative pathologic risk factors. At the same time, operation therapy can improve the preservation of ovarian function in young patients with cervical cancer, quality of life. Conclusion： Neoadjuvant chemotherapy could improve the clinical effects of surgery on locally advanced cervical cancer.