巨块型宫颈癌新辅助化疗不同途径的疗效分析

目的：观察比较新辅助化疗不同化疗途径对巨块型宫颈癌的疗效及毒副反应。方法回顾性分析2004年12月至2009年12月金华市中心医院收治的87例巨块型（局部肿瘤直径≥4cm）宫颈癌患者的临床病理资料，按照化疗途径的不同分为动脉化疗组和静脉化疗组，比较两组的疗效和毒副反应。结果动、静脉化疗组中，化疗有效率分别为82．5％和80．8％，差异无统计意义（P＞0．05）；为达到可以手术的程度，动、静脉组中接受第二疗程化疗者分别占22．5％和53．2％，差异有统计学意义（P＜0．01）；动、静脉组中化疗后消化道反应和血液系统毒副反应发生率差异无统计学意义（均P＞0．05）；3年、5年生存率动脉组分别为82．5％和77．5％，静脉组分别为80．4％和73．9％，两组分别比较，差异均无统计学意义（P＞0．05）。结论新辅助化疗对巨块型子宫颈癌治疗是安全有效的，静脉化疗使用简单、经济，易于在基层推广；动脉化疗对于控制局部进展型子宫颈癌更有效。

Therapeutic effects of different pathways of neoadjuvant chemotherapy on bulky cervical cancer

Objective To investigate the therapeutic effects of different pathways of neoadjuvant chemotherapy in bulky cervical cancer and their toxic and adverse reactions.Methods A retrospective study was carried out on 87 patients with bulky cervical cancers ( local diameter of tumor≥4cm) admitted to Jinhua Hospital Affiliated of Zhejiang University from December 2004 to December 2009.They were separated into arterial interventional chemotherapy group ( AICG) and venous chemotherapy group ( VCG) , and the therapeutic, toxic and adverse reactions of two groups were analyzed and compared.Results The therapeutic effective rates of AICG and VCG were 82.5%and 80.8%, respectively, and there was no statistical difference between two groups(P>0.05).There was 22.5% and 53.2% patients receiving second chemotherapy in AICG group and VCG group, respectively, and the difference was significant (P<0.01).The differences in toxic and adverse reactions on digestive system and hematological system after chemotherapy between two groups were not significant ( all P>0.05).The 3-and 5-year survival rates of AICG were 82.5%and 77.5%, respectively, and those of VCG were 80.4%and 73.9%, respectively.The differences between two groups were not significant(all P>0.05).Conclusion Neoadjuvant chemotherapy on bulky cervical cancer before surgery is safe and effective.Venous chemotherapy is easy, inexpensive, and convenient to carry out in primary hospitals.Arterial interventional chemotherapy is more effective on locally advanced cervical cancer.