ⅠB2~ⅡB期宫颈癌患者术后单纯辅助化疗与同步放化疗的疗效观察

摘要/Abstract

摘要： 目的：探讨术前新辅助化疗结合宫颈癌根治术及术后单纯化疗在ⅠB2~ⅡB期宫颈癌的治疗效果。方法：接受新辅助化疗+宫颈癌根治术的79例ⅠB2~ⅡB期宫颈癌患者被纳入本研究。根据术后辅助治疗方法不同分为术后化疗组（47例）和术后放疗/放化疗组（32例），对治疗效果进行比较和评价。新辅助化疗及术后化疗方案为BIP（博来霉素+异环磷酰胺+顺铂/卡铂）或TP（紫杉醇+顺铂/卡铂）。新辅助化疗疗程平均(1.1±0.3)个，术后化疗疗程平均(3.4±1.2)个。结果：新辅助化疗的总有效率为88.6%，患者可以耐受新辅助化疗和术后化疗的毒副作用，中位随访时间42个月。术后化疗组和放疗/放化疗组3年无瘤生存率分别为88.5%和84.3%，3年总生存率分别为90.3%和86.4%，差异均无统计学意义。两组患者分别有5例和7例患者肿瘤复发，复发率分别为10.6%和21.8%。结论：新辅助化疗结合宫颈癌根治术及术后单纯化疗对于ⅠB2~ⅡB期宫颈癌患者是一种可行的治疗选择，患者可耐受化疗毒副作用并获得较好的近、远期疗效。

关键词: 宫颈肿瘤, 妇科外科手术, 药物疗法, 治疗结果

Abstract: To evaluate the effectiveness of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy plus postoperative chemotherapy but no radiotherapy for stage ⅠB2-ⅡB cervical cancer. Methods: Seventy-nine patients with stage ⅠB2-ⅡB cervical cancer were treated with NAC followed by radical hysterectomy. According to different adjuvant therapies, patients were divided into postoperative chemotherapy group (47 cases) and postoperative radiotherapy/concurrent chemoradiothe-rapy group (32 cases). Regimens for NAC and postoperative chemotherapy were BIP (bleomycin+ ifosfamide+ cisplatin/carboplatin) or TP (paclitaxel+ cisplatin/carboplatin). An average of 1.1±0.3 cycles of NAC and 3.4±1.2 cycles of postoperative chemotherapy were prescribed. Results: Toxicities due to chemotherapy were generally tolerable. Overall response rate of NAC was 88.6%. With a median follow-up period of 42 months, the three-year progression-free survival rates of the two groups were 88.5% and 84.3%, the total survival rates were 90.3% and 86.4%, respectively. There was no statistically significant difference. The recurrent rates were 10.6% and 21.8% in the two groups. In the absence of radiotherapy, pelvic recurrence was observed in two patients; the other three had distant metastases. Conclusion:The results indicate that NAC followed by surgery plus postoperative chemotherapy but no radiotherapy offers a viable option in the treatment of stage ⅠB2-ⅡB cervical cancer. The patients can tolerate the side effects of chemotherapy with better efficacy.

Key words: Uterine cervical neoplasms, Gynecologic surgical procedures, Drug therapy, Treatment outcome

马珂，杨仪赫，杨曦，冯兆亿，刘桐宇，温宏武，廖秦平. ⅠB2~ⅡB期宫颈癌患者术后单纯辅助化疗与同步放化疗的疗效观察[J]. 北京大学学报（医学版）, 2013, 45(6): 910-915.

MA Ke, YANG Yi-he, YANG Xi, FENG Zhao-Yi, LIU Tong-yu, WEN Hong-wu, LIAO Qin-ping. Efficacy of postoperative simple chemotherapy and concurrent chemoradiotherapy in FIGO stage ⅠB2-ⅡB cervical cancer[J]. Journal of Peking University(Health Sciences), 2013, 45(6): 910-915.

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