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目的:术前新辅助化疗在Ib-IIa期宫颈癌治疗中的意义。方法:将Ib-IIa期宫颈癌62例患者分为3组,直接手术者19例,静脉化疗组20例,介入化疗组23例,并将2种新辅助化疗后手术与直接手术的疗效进行对比分析。结果:(1)介入化疗组有效16例(69.57%),静脉化疗组有效11例(55.00%),新辅助化疗2组有效率比较差异有统计学意义(P<0.05),介入化疗组完全缓解率及部分缓解率均高于静脉化疗组。(2)新辅助化疗组组织病理学评价:介入化疗组II级14例(60.86%),III级4例(17.39%),有效18例(78.26%)。静脉化疗组II级9例(45.00%),III级3例(15.00%),有效12例(60.00%),新辅助化疗2组有效率比较差异有统计学意义(P<0.05)。介入下辅助化疗可明显改善Ib-IIa期宫颈癌的疗效。(3)新辅助化疗组与直接手术组的术中出血量和手术时间比较差异无统计学意义(P<0.05)。结论:术前介入下新辅助化疗可成为Ib-IIa期宫颈癌患者的治疗途径,明显改善宫颈癌的治疗结果。
Objective: Preoperative neoadjuvant chemotherapy in the treatment of Ib-IIa cervical cancer significance. Methods: Sixty-two patients with stage Ib-IIa cervical cancer were divided into three groups: direct surgery in 19 cases, intravenous chemotherapy in 20 cases and interventional chemotherapy in 23 cases. The effects of two kinds of neoadjuvant chemotherapy after operation and direct operation Comparative analysis. Results: (1) The interventional chemotherapy group was effective in 16 cases (69.57%), and the intravenous chemotherapy group (11 cases) was effective in 55 cases (55.00%). The effective rate of neoadjuvant chemotherapy group was statistically significant (P < The response rate and partial response rate were higher than those in the intravenous chemotherapy group. (2) Histopathological evaluation of neoadjuvant chemotherapy: 14 cases (60.86%) in grade II, 4 (17.39%) in grade III and 18 (78.26%) were effective in interventional chemotherapy. There were 9 cases (45.00%) in grade II, 3 cases (15.00%) in grade III, and 12 cases (60.00%) in group IV. There was significant difference in the effective rate of neoadjuvant chemotherapy between the two groups (P <0.05). Interventional adjuvant chemotherapy can significantly improve the efficacy of Ib-IIa cervical cancer. (3) There was no significant difference in operative blood loss and operation time between neoadjuvant chemotherapy group and direct operation group (P <0.05). Conclusions: Neoadjuvant chemotherapy with preoperative intervention can be a therapeutic approach for patients with stage Ib-IIa cervical cancer and significantly improve the outcome of cervical cancer.