Analysis on the Short-term Curative Effect of Neoadjuvant Chemotherapy on the Early-stage Bulky Cervical Carcinoma_West China Medical Journal

Authors：

ZHOU Ping

Yixing People’s Hospital, Yixing, Jiangsu 214200, P. R. China;

Corresponding author：

Keywords：

宫颈肿瘤; 新辅助化疗; 近期疗效

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

【摘要】　目的　评价早期巨块型宫颈癌患者术前行新辅助化学疗法的近期疗效。　方法　回顾分析2005年10月-2010年6月收治的Ⅰb~Ⅱa期巨块型宫颈癌患者90例患者的临床资料。根据术前是否行化学疗法将患者分为两组；新辅助化学疗法（neoadjuvant chemotherapy，NACT）组50例，术前予静脉化学疗法或子宫动脉灌注化学疗法治疗1～3个疗程;直接手术组40例，直接行根治性手术。比较新辅助化学疗法前后病灶大小变化，化学疗法不良反应，手术情况及术后病理情况。　结果　 NACT组总有效率86%（43/50），鳞癌疗效优于腺癌，动脉与静脉化学疗法近期有效率比较，两组差异无统计学意义（P gt;0.05）。NACT不良反应小。NACT组术中出血少于直接手术组，两者差异有统计学意义（P lt;0.05）。两组深肌层浸润、淋巴结转移、脉管浸润差异均无统计学意义（P gt;0.05），NACT组宫旁浸润率低于直接手术组。　结论　术前NACT对早期巨块型宫颈癌患者近期疗效显著。
【Abstract】　Objective　 To evaluate the short-term curative effect of preoperative neoadjuvant chemotherapy on the early-stage bulky cervical carcinoma. 　Methods　 We retrospectively analyzed the clinical data of 70 patients with bulky ⅠB-ⅡA cervical carcinoma treated in our hospital between October 2005 and June 2010. Based on whether the patients received chemotherapy, they were divided into two groups: neoadjuvant chemotherapy group (NACT group) and direct surgery group. In the former group, there were 50 patients who underwent surgery after 1 to 3 cycles of preoperative chemotherapy by uterus artery infusion or intravenous chemoembolization. For the 40 patients in the latter group, direct radical surgery was performed. The size of the tumor before and after chemotherapy, the operation conditions and the postoperative pathological conditions of patients between the two groups were compared and the adverse reactions of neoadjuvant chemotherapy were analyzed as well.　Results　 The total effective rate of NACT group was 86% (43/50). The response to chemotherapy in squamous cell caner was significantly higher than adenocarcinoma. There was no statistical difference between arterial and venous chemotherapy in terms of immediate effect (P gt;0.05). The incidence of adverse reactions of neoadjuvant chemotherapy was low. There was significant difference between the NACT group and the direct surgery group in intraoperative bleeding (P lt;0.05). There were no significant differences between the above two groups in deep muscularis infiltration rate, lymph node metastasis rate and vascular invasion rate. However, the parametrial infiltration rate for the NACT group was lower than that for the direct surgery group.　Conclusion　 Preoperative neoadjuvant chemotherapy on patients with early-stage bulky cervical carcinoma has a remarkable immediate curative effect.

Citation： ZHOU Ping. Analysis on the Short-term Curative Effect of Neoadjuvant Chemotherapy on the Early-stage Bulky Cervical Carcinoma. West China Medical Journal, 2011, 26(4): 517-520. doi: Copy

1.	Hockel M, Dornhofer N. The hydra phenomenon of cancer: why tumors recur locally after microscopically complete resection[J]. Cancer Res, 2005, 65(8): 2997-3002.
2.	陈敏, 李玉萍, 梁月华. 宫颈癌新辅助动脉化疗临床疗效观察[J]. 中国实用妇科与产科杂志, 2007, 23(9): 718-719.
3.	凌斌, Bin L. 子宫颈癌诊断与治疗的新进展[J]. 中国实用妇科与产科杂志, 2007, 23(1): 23-25.
4.	程晓东, 吕卫国, 叶枫, 等. 局部晚期子宫颈癌新辅助化疗价值的评估[J]. 中华妇产科杂志, 2006, 41(2): 95-98.
5.	Mizuno K, Kidokoro K, Miyazaki K, et al. Neoadjuvant chemotherapy with intra-arterial infusion in the treatment of advanced cervical cancer[J]. Gan To Kagaku Ryoho, 2005, 32(6): 815-819.
6.	王文, 蒋国庆, 高敏, 等. 术前新辅助化疗对宫颈癌患者临床疗效的初步观察[J]. 中国妇产科临床杂志,2009,10(2): 105-108.
7.	常丽锦, 王建六, 魏丽惠. 子宫颈癌的新辅助化疗[J]. 现代妇产科进展, 2003, 12(2): 135-136.
8.	徐丽萍, 邵华江. 35例ⅠB2～ⅡB期宫颈癌术前介入治疗临床分析[J]. 实用妇产科杂志, 2009, 25(5): 296-298.
9.	Park DC, Kim JH, Lew YO, et al. Phase II trial of neoadjuvant paclitaxel and cisplatin in uterine cervical cancer[J]. Gynecol Oncol, 2004, 92(1): 59-63.
10.	王平, 彭芝兰, 张家文, 等. 子宫颈癌新辅助化疗中不同化疗途径的疗效比较[J]. 中华妇产科杂志, 2005, 40(4): 227-230.
11.	任亚娟, 糜若然. 宫颈癌新辅助化疗临床应用及预后影响因素[J]. 国外医学(妇产科学分册), 2007, 34(6): 415-418.
12.	Choi YS, Sin JI, Kim JH, et al. Survival benefits of neoadjuvant chemotherapy followed by radical surgery versus radiotherapy in locally advanced chemoresistant cervical cancer[J]. J Korean Med Sci, 2006, 21(4): 683-689.

1. 　Hockel M, Dornhofer N. The hydra phenomenon of cancer: why tumors recur locally after microscopically complete resection[J]. Cancer Res, 2005, 65(8): 2997-3002.
2. 　陈敏, 李玉萍, 梁月华. 宫颈癌新辅助动脉化疗临床疗效观察[J]. 中国实用妇科与产科杂志, 2007, 23(9): 718-719.
3. 　凌斌, Bin L. 子宫颈癌诊断与治疗的新进展[J]. 中国实用妇科与产科杂志, 2007, 23(1): 23-25.
4. 　程晓东, 吕卫国, 叶枫, 等. 局部晚期子宫颈癌新辅助化疗价值的评估[J]. 中华妇产科杂志, 2006, 41(2): 95-98.
5. 　Mizuno K, Kidokoro K, Miyazaki K, et al. Neoadjuvant chemotherapy with intra-arterial infusion in the treatment of advanced cervical cancer[J]. Gan To Kagaku Ryoho, 2005, 32(6): 815-819.
6. 　王文, 蒋国庆, 高敏, 等. 术前新辅助化疗对宫颈癌患者临床疗效的初步观察[J]. 中国妇产科临床杂志,2009,10(2): 105-108.
7. 　常丽锦, 王建六, 魏丽惠. 子宫颈癌的新辅助化疗[J]. 现代妇产科进展, 2003, 12(2): 135-136.
8. 　徐丽萍, 邵华江. 35例ⅠB2～ⅡB期宫颈癌术前介入治疗临床分析[J]. 实用妇产科杂志, 2009, 25(5): 296-298.
9. 　Park DC, Kim JH, Lew YO, et al. Phase II trial of neoadjuvant paclitaxel and cisplatin in uterine cervical cancer[J]. Gynecol Oncol, 2004, 92(1): 59-63.
10. 　王平, 彭芝兰, 张家文, 等. 子宫颈癌新辅助化疗中不同化疗途径的疗效比较[J]. 中华妇产科杂志, 2005, 40(4): 227-230.
11. 　任亚娟, 糜若然. 宫颈癌新辅助化疗临床应用及预后影响因素[J]. 国外医学(妇产科学分册), 2007, 34(6): 415-418.
12. 　Choi YS, Sin JI, Kim JH, et al. Survival benefits of neoadjuvant chemotherapy followed by radical surgery versus radiotherapy in locally advanced chemoresistant cervical cancer[J]. J Korean Med Sci, 2006, 21(4): 683-689.

West China Medical Journal

Analysis on the Short-term Curative Effect of Neoadjuvant Chemotherapy on the Early-stage Bulky Cervical Carcinoma

Abstract Full text Figures/Tables Video References Cited by

Format

Content