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目的探讨紫杉醇联合顺铂在局部晚期宫颈癌新辅助化疗中的临床疗效。方法选取2011年12月至2013年12月间山东省郓城县人民医院收治的160例行宫颈癌根治术的局部晚期宫颈癌患者,采用随机数字表法分为试验组与对照组,每组80例。对照组患者采用宫颈癌根治术,试验组患者采用术前紫杉醇联合顺铂新辅助化疗+宫颈癌根治术,对比两组患者的近期疗效、手术及转移情况、治疗前后患者负性情绪、术后随访3年生存率及复发率。结果试验组患者近期临床总有效率为62.5%,高于对照组患者的42.5%,差异有统计学意义(P<0.05)。试验组患者手术时间、术中出血量、宫旁淋巴结转移率及盆腔淋巴结转移率分别为(232.29±40.23)min、(421.34±149.34)ml、2.5%和5.0%,对照组患者分别为(320.90±45.67)min、(550.53±160.59)ml、12.5%和15.0%,两组比较,差异均有统计学意义(均P<0.05)。试验组患者治疗后焦虑自评量表(SAS)和抑郁自评量表(SDS)评分分别为(46.23±5.09)分和(45.34±5.10)分,对照组患者分别为(52.45±5.33)分和(53.19±5.28)分,两组患者较治疗前均降低,且试验组改善更显著,差异均有统计学意义(均P<0.05)。试验组患者术后1年、2年、3年生存率和复发率分别为95.0%、85.0%、67.5%、2.5%、5.0%和10.0%,对照组患者分别为87.5%、75.0%、47.5%、7.5%、15.0%和25.0%,两组比较,差异均有统计学意义(均P<0.05)。结论宫颈癌根治术前给予紫杉醇联合顺铂新辅助化疗,可获得更加显著的近期疗效及远期生存率,复发率低,安全性高,可在临床推广。
Objective To investigate the clinical efficacy of paclitaxel plus cisplatin in neoadjuvant chemotherapy for locally advanced cervical cancer. Methods From December 2011 to December 2013 in Shandong Province Tancheng County People’s Hospital admitted 160 cases of cervical cancer patients with locally advanced cervical cancer, using random number table divided into experimental group and control group, each group 80 cases. Patients in the control group were treated with radical resection of cervical cancer. Patients in the test group were treated with preoperative paclitaxel combined with cisplatin neoadjuvant chemotherapy and cervical cancer radical mastectomy. The curative effect, operation and metastasis were compared between the two groups before and after treatment. Follow-up 3-year survival rate and recurrence rate. Results The total clinical effective rate of the trial group was 62.5%, which was higher than that of the control group (42.5%), the difference was statistically significant (P <0.05). The operation time, intraoperative blood loss, para-lymph node metastasis rate and pelvic lymph node metastasis rate were (232.29 ± 40.23) min, (421.34 ± 149.34) ml, 2.5% and 5.0% in the test group and 320.90 ± 45.67) min, (550.53 ± 160.59) ml, 12.5% and 15.0%, respectively. There was significant difference between the two groups (all P <0.05). The anxiety self-rating scale (SAS) and depression self-rating scale (SDS) scores of the experimental group were (46.23 ± 5.09) and (45.34 ± 5.10) points after treatment, respectively, while those of the control group were (52.45 ± 5.33) And (53.19 ± 5.28) points respectively. Both groups were lower than before treatment, and the improvement in the experimental group was more significant (all P <0.05). The 1-year, 2-year and 3-year survival rates and recurrence rates of patients in the test group were 95.0%, 85.0%, 67.5%, 2.5%, 5.0% and 10.0% respectively, while those in the control group were 87.5%, 75.0% and 47.5% %, 7.5%, 15.0% and 25.0%, respectively. There was significant difference between the two groups (all P <0.05). Conclusion Paclitaxel combined with cisplatin neoadjuvant chemotherapy before radical resection of cervical cancer can achieve more significant short-term and long-term survival, low recurrence rate and high safety. It can be used clinically.