山西医科大学学报2017，Vol.48Issue(11)：1177-1182,6.DOI:10.13753/j.issn.1007-6611.2017.11.019
局部晚期宫颈癌同步放化疗后的手术探讨
Surgical treatment of locally advanced cervical cancer after concurrent chemoradiotherapy
摘要
Abstract
Objective To explore the surgical scope and clinical efficacy of locally advanced cervical cancer(LACC) after concurrent chemoradiotherapy(CCRT).Methods The clinical data of 444 LACC patients with stage Ⅰ B2-Ⅱ B receiving robot-assisted radical surgery from January 2013 to December 2016 were retrospectively analyzed.These patients were divided into two groups according to the treatment of preoperative CCRT.Totally 264 patients with preoperative CCRT were in CCRT + radical surgery group,while 180 pa tients without receiving any adjuvant therapy before operation were in radical surgery group.The operative time,intraoperative blood loss,postoperative hospital stay,intraoperative and postoperative complications,postoperative pathological data,postoperative adjuvant radiotherapy and chemotherapy,and recurrence were analyzed.The clinical efficacy of preoperative concurrent chemoradiotherapy in CCRT + radical surgery group was analyzed statistically.Results There was no significant difference in age,BMI and pathological type between the two groups(P ＞ 0.05).There was no significant difference in operation time,intraoperative blood loss,postoperative hospital stay,postoperative ventilation time and postoperative catheter indwelling time between the two groups(P ＞ 0.05).The total effective rate of preoperative CCRT(CR + PR) was 92.6％,including 9.1％ for CR and 87.1％ for PR.The positive rates of deep cervical stromal invasion,lymph node metastasis and lymphatic vessel invasion were higher in radical surgery group than those in CCRT + radical surgery group(P ＜ 0.05).Totally 24 patients received adjuvant therapy in the CCRT + radical surgery group and 162 patients in radical surgery group,and there was statistically significant difference(P ＜ 0.05).The incidence of leg edema,radiation enteritis and radioactive cystitis was significantly higher in radical surgery group than that in CCRT + radical surgery group(P ＜0.05).The 3-year progression-free survival rate was 91.7％ in CCRT + radical surgery group and 90.0％ in radical surgery group,and there was no sig nificant difference between the two groups(P ＞ 0.05).The 3-year overall survival rates were 93.6％ and 92.8％ in CCRT + radical surgery group and radical surgery group,respectively,and there was no significant difference between the two groups (P ＞ 0.05).Conclusion The preoperative CCRT combined with radical surgery for LACC can achieve better clinical curative effect but not increase in the incidence of intraoperative and postoperative complications.关键词
术前同步放化疗/局部晚期宫颈癌/根治性手术Key words
preoperative concurrent chemoradiotherapy/locally advanced cervical cancer/radical surgery分类
医药卫生引用本文复制引用
葛俊丽,孙季冬,吕小慧,李佳,荆如,陈必良..局部晚期宫颈癌同步放化疗后的手术探讨[J].山西医科大学学报,2017,48(11):1177-1182,6.基金项目
国家自然科学基金资助项目(81301921) （81301921）
西京医院临床高新技术基金资助项目(XJGX13LZ04) （XJGX13LZ04）
