摘要
Abstract
Objective:To evaluate the efficacy and security of preoperative brachyther-apy combinded concurrent chemotherapy ( preoperative brachy-chemothepapy ) in the compre-hensive treatment for patients with FIGO stage ⅠB2 andⅡA2 cervical cancer. Methods:Total of 82 patients with FIGO stage ⅠB2 andⅡA2 cervical cancer were enrolled retrospectively treated in the department of Gynaecology of Drum Tower Hospital affiliated to Medical College of Nanjing University from June 2010 to May 2015 . According to the different preoperative regi-mens,they were categorized into three groups,including directly surgical group ( Group A,27 cases) ,neoadjuvant chemotherapy group ( Group B,41 cases) ,and brachy-chemotherapy group ( Group C,14 cases) . Radical hysterectomy was performed following the later two regimens. To compare three groups of postoperative hospital stay, average intraoperative blood loss, average surgical time,clinical pathological remission rate,incidence of complications and recent survive time. Results:Postoperative hospital stay was significantly more in group B than group A. Intra-operative blood loss was significantly more in group B than in group C. These difference were statistically significant (P<0. 05). Vascular invasion rate,deep muscle invasion rate and lymph node positive rate in group C were lower than in group A and B. All these difference were statis-tically significant (P<0. 05),and no statistically significant difference were noted in latter two groups (P>0. 05),and three groups had no significant difference in nerve invasion rate (P>0. 05 ) . The preoperative therapeutic effective rate of 85 . 7% in group C was much higher than 36 . 4% in group B with a statistically significant difference ( P<0 . 05 ) . The occurrence rate of sur-gery-related complications and nerve invasion rate had no statistically significant difference a-mong three groups. Median survival time and 3-year survival rate in group A,B and C were 41. 2 months(95%CI:33. 8 ~48. 5 months) and 63. 9%,33. 8 months(95%CI:28. 9 ~38. 7 months)and 53. 1%,48. 1 months(95%CI:37. 5 ~58. 7 months)and 68. 2% respectively, where there were no statistically significant difference among three groups ( P>0 . 05 ) . Lymph node metastasis was a independent risk factor of decreasing survival time ( P<0 . 05 ) . Conclu-sions:For no-significantly increasing the occurrence rate of surgery-related complications,surgi-cal time,intraoperative blood loss,preoperative brachytherapy combinded concurrent chemother-apy is a safe and effective regimen for patients with stage ⅠB2 andⅡA2 cervical cancer.关键词
宫颈癌/近距离放疗/后装近距离放疗联合同步化疗/新辅助化疗/近期疗效/病理缓解/手术并发症Key words
Cervical neoplasm/Branchytherapy/Afterloading Brachytherapy combind-ed concurrent chemotherapy/Neoadjuvant chemotherapy/Short-term efficacy/Pathology remis-sion/Surgery-related complications分类
医药卫生
