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两种新辅助化疗给药方式治疗ⅠB~ⅡB期子宫颈癌临床对比研究
作者:邓艳丽  钟帮英 
单位:老河口市第一医院妇产科  湖北 老河口 441800 
关键词:宫颈肿瘤/药物疗法 化学疗法 辅助 输注 静脉内 动脉 化学栓塞 治疗性 
DOI:R737.33;R730.53
出版年,卷(期):页码:2018,33(4):343-347
摘要:

目的 探讨术前新辅助化疗静脉给药和动脉介入栓塞给药方案治疗ⅠB~ⅡB期子宫颈癌临床疗效和安全性差异。方法 研究对象选取ⅠB~ⅡB期子宫颈癌患者100例,以随机数字表法分为静脉给药组(50例)和动脉介入栓塞给药组(50例),分别在术前新辅助化疗多西他赛75 mg/m2+顺铂60 mg/m2,必要时间隔3周行下1个周期化疗,分别采用静脉给药和动脉介入栓塞给药;比较两组患者近期疗效、随访3年生存率和复发率、可手术率、术前住院时间、新辅助化疗至手术时间、总治疗费用及不良反应发生率。结果 两组患者近期疗效、3年生存率、3年复发率和可手术率比较,差异均无统计学意义(均P>0.05)。动脉介入栓塞给药组患者术前住院时间和新辅助化疗至手术时间均短于静脉给药组(均P<0.05)。静脉给药组患者总治疗费用低于动脉介入栓塞给药组(P<0.05)。动脉介入栓塞给药组患者Ⅲ~Ⅳ度不良反应发生率低于静脉给药组(P<0.05)。结论 2种术前新辅助化疗方案治疗ⅠB~ⅡB期子宫颈癌总体疗效接近。但动脉介入栓塞给药可有效缩短治疗时间,降低严重不良反应发生风险,适用于经济条件较佳者。

Objective To compare the clinical efficacy and safety of two administration routes (intravenous and arterial embolization) of neoadjuvant chemotherapy scheme for patients with stageⅠB-ⅡB cervical cancer. Methods One-hundred patients with stageⅠB-ⅡB cervical cancer were randomly assigned to receive neoadjuvant chemotherapy by intravenous administration (n=50) or arterial embolization (n=50). Both groups were treated with 75 mg/m2 docetaxel and 60 mg/m2 cisplatin before the surgery. An additional cycle of chemotherapy was administered at 3 weeks after the first treatment when necessary. The short-term clinical efficacy,3-year survival and recurrence rate,operational rate,the length of preoperational stay,the time length between neoadjuvant chemotherapy and surgery,total treatment cost and incidence of adverse effects were compared between the two groups. Results There were no significant differences in the short-term clinical efficacy,3-year survival and recurrence rates,and operational rates between the 2 groups (all P>0.05). Nevertheless,the preoperational duration and the time length between chemotherapy and surgery were shorter in the arterial embolization group than those in intravenous administration group (both P<0.05). On the other hand,the total treatment cost of the intravenous administration group was significant less than that365bet娱乐官网网址 of arterial embolization group(P<0.05). Finally,the incidence of level Ⅲ-Ⅳ adverse effects was lower in the arterial embolization group than that the intravenous administration group(P<0.05). Conclusion The total clinical efficacy is comparable between the intravenous and arterial intervention approaches of neoadjuvant chemotherapy in the treatment of stage ⅠB-ⅡB cervical cancer. However,the arterial embolization approach may shorten the treatment time and reduce serious adverse effects. On the other hand it is more costly.

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