【摘要】：目的：探討新輔助化療治療局部晚期宮頸癌的近期臨床療效。 方法：選取52例局部晚期宮頸癌患者，臨床分期為Ⅰb2、Ⅱa2期，分為治療組（A組）和對照組（B組），治療組在接受2個療程的TP方案化療后再行宮頸癌根治術(shù)，對照組則直接行宮頸癌根治術(shù)。通過盆腔MRI測量治療組化療前后宮頸腫瘤體積、盆腔淋巴結(jié)最大直徑，通過陰道彩色超聲多普勒測量化療前后宮頸局部病灶的血流指數(shù)（RI）并進行對照，并比較兩組在手術(shù)時間、術(shù)中出血量及術(shù)后病理等方面的差異，以此來評估新輔助化療近期療效。 結(jié)果：化療反應(yīng)率總的臨床有效率達85.44％；首次化療前宮頸癌平均體積為24688.03±7659.23mm3，末次化療后宮頸癌平均體積為6327.11±1169.02mm3；首次化療前盆腔淋巴結(jié)最大直徑平均值為17.81±2.37mm，，末次化療后盆腔淋巴結(jié)最大直徑平均值為9.19±1.38mm；首次化療前RI平均值為0.386±0.035，末次化療后RI平均值為0.489±0.061，上述數(shù)據(jù)前后對照差異具有統(tǒng)計學(xué)意義（P值均小于O.05)。手術(shù)時間治療組平均為3.6±0.4h、對照組平均為4.2±0.5h，術(shù)中出血量治療組平均為430±157ml、對照組平均為720±142mL；治療組術(shù)后宮頸病灶陽性率為88.46%；治療組和對照組的盆腔淋巴結(jié)陽性率分別為11.53%、26.92%；治療組和對照組脈管受累陽性率分別為15.38%、38.46%；治療組和對照組浸潤深層間質(zhì)發(fā)生率分別為19.23%、53.84%，以上兩組數(shù)據(jù)比較差異具有統(tǒng)計學(xué)意義（P值均小于O.05）�；煵涣挤磻�(yīng)骨髓抑制I度為61.53%，Ⅱ度為38.46%，胃腸道反應(yīng)I度為45.45%，Ⅱ度為36.36%，Ⅲ度為18.18%。 結(jié)論：新輔助化療能明顯縮小宮頸癌病灶體積、減小盆腔淋巴結(jié)直徑、增加RI指數(shù)，從而為手術(shù)切除創(chuàng)造了條件。但新輔助化療同時也掩蓋宮頸間質(zhì)深層浸潤、脈管受累、及淋巴結(jié)轉(zhuǎn)移的病情，干擾了臨床醫(yī)師對宮頸癌手術(shù)后后續(xù)治療方案的制定，患者是否獲益值得商榷。
[Abstract]:Objective: to investigate the short-term clinical effect of neoadjuvant chemotherapy for locally advanced cervical cancer. Methods: 52 patients with locally advanced cervical cancer were divided into two groups: treatment group (group A) and control group (group B). The control group was treated with radical resection of cervical cancer. The volume of cervical tumor and the maximum diameter of pelvic lymph nodes were measured by pelvic MRI before and after chemotherapy. The blood flow index (RI) was measured by vaginal color Doppler ultrasound before and after chemotherapy, and the operation time was compared between the two groups. To evaluate the short-term efficacy of neoadjuvant chemotherapy by the difference of intraoperative bleeding volume and postoperative pathology. Results: the total effective rate of chemotherapy was 85.44 mm, the average volume of cervical cancer was 24688.03 鹵7659.23 mm 3 before the first chemotherapy and 6327.11 鹵1169.02 mm 3 after the last chemotherapy. The mean maximum diameter of pelvic lymph nodes was 17.81 鹵2.37 mm before the first chemotherapy and 9.19 鹵1.38 mm after the last chemotherapy. The mean RI was 0.386 鹵0.035 before the first chemotherapy and 0.489 鹵0.061 after the last chemotherapy (P < 0.05). The average time of operation was 3.6 鹵0.4h in the treatment group, 4.2 鹵0.5h in the control group, 430 鹵157ml in the treatment group and 720 鹵142mL in the control group, and the positive rate of the cervical lesion in the treatment group was 88.46ml, the positive rate of the pelvic lymph nodes in the treatment group and the control group was 11.53 and 26.92respectively. The positive rate of vascular involvement in the treatment group and the control group was 15.38 and 38.46, respectively, and the incidence of infiltrating deep stroma in the treatment group and the control group was 19.23 and 53.84, respectively. The difference between the above two groups was statistically significant (P < 0.05). The side effects of chemotherapy were as follows: I was 61.53, 鈪

本文編號：2165261