目的:比较两种新辅助化疗方法对Ⅰb2~Ⅱb期宫颈癌的近期疗效。方法:进行新辅助化疗的Ⅰb2~Ⅱb期宫颈癌患者78例,对患者的临床病理资料进行回顾性分析,其中经静脉全身化疗者41例(静脉组),经子宫动脉插管化疗者37例(动脉组)。结果:静脉组患者经新辅助化疗后总有效率为85%(35/41),动脉组为92%(34/37),两组差异无统计学意义(P〉0.05)。两组患者新辅助化疗后手术时间、出血量和并发症发生率比较,差异无统计学意义(P〉0.05)。Ⅱb期患者经新辅助化疗后手术,术后病理检查发现盆腔淋巴结转移率无统计学差异(P〉0.05),宫旁浸润率两组比较动脉组发生率低于静脉组(P=0.03)。结论:两种途径的新辅助化疗有效率和手术难度相当,子宫动脉介入化疗对改善宫旁浸润效果更好。
Objective:To compare the recent effect between intra-arterial and intra-venous neoadjuvant chemotherapy(NACT) in stageⅠb2-Ⅱb cervical cancer. Methods:A retrospective analysis was done on 41 cases of intra-venous NACT and 37 eases of intra-arterial NACT for stage I b2-Ⅱb cervical cancer. Results:The effective rate of intra-venous NACT and intra-arterial NACT was 85%(37/41) and 92%(35/37) respectively(P0.05).There were no significant differences in surgery time,blood loss and post-operative morbidity between these two groups.There were no significant differences in lymph node metastasis rate between these two groups(P0.05).Pathological parametrial positive rate after NACT in arterial group(8.3%)was significantly lower than that of venous group(50%)(P0.05). Conclusion:Effective rate,operative rate and surgical difficulties are similar between the intra-arterial and intra-venous NACT for stage I b2-Ⅱb cervical cancer.Arterial NACT show better effect on parametrical infiltration.