新辅助介入化疗在局部晚期宫颈癌治疗中的价值

Clinical Efficacy of Neo-Adjuvant Intra-Arterial Chemotherapy for Locally Advanced Cervical Carcinoma

  • 摘要:
      目的  探讨新辅助介入化疗在局部晚期宫颈癌临床治疗中的作用。
      方法  对87例局部晚期宫颈癌患者进行回顾性分析, 根据新辅助化疗的不同途径分为新辅助介入化疗(IA-NAC)组42例和新辅助静脉化疗(IV-NAC)组45例。化疗方案为DDP(顺铂)60mg/m2+BLM(博来霉素)25 mg/m2+VCR(长春新碱)1 mg/m2+MMC(丝裂霉素)10mg/m2; 或DDP 70mg/m2+ADM(阿霉素)30 mg/m2。化疗后根据检查决定手术或放疗。评价两组的近期和远期疗效、手术切除率、病理学变化和不良反应。
      结果  两组近期疗效均较好, 但无显著性差异; 3、5年生存率两组比较差异无统计学意义(P > 0.05);Ⅱb期患者的手术率IA-NAC组高于IV-NAC组, IA-NAC组平均生存时间较IV-NAC组长(P < 0.05)。
      结论  新辅助动脉介入化疗的组织缓解率、平均生存时间较静脉化疗好, 但未能提高其远期生存率。

     

    Abstract:
      Objective  The aim of the current study is to determine the clinical efficacy of neo-adjuvant intra-arterial chemotherapy in locally advanced cervical carcinoma.
      Methods  From January 1997 to December 2005, 87 previously untreated patients with stage IB2-IIB cervical cancers were randomly divided into two groups: IA-NAC and IV-NAC.The drugs used in the current study included cisplatin(60 mg/m2) with mitomycin(10 mg/m2), bleomycin(25 mg/m2), and vincristine(1 mg/m2) or cisplatin(70 mg/m2) with doxorubicin hydrochloride(30 mg/m2) for one course.The response was assessed using pelvic and histological examinations.
      Results  Significant differences in the overall clinical response rate between the two groups were observed.The three-and five-year survival rates were not significantly different either.The operability ofⅡb stage patients was higher in IA-NAC group(P < 0.05) compared with theIV-NAC group, and no significant differences in the mean survival time was found between the two groups(P < 0.05).
      Conclusion  Neo-adjuvant intra-arterial chemotherapy can increase the operability rate in patients with stage IIB cervical cancer and can raise the mean survival time.However, neo-adjuvant intra-arterial chemotherapy does not improve long-term survival rates compared with intravenous chemotherapy.

     

/

返回文章
返回