术前子宫动脉化疗栓塞治疗Ⅰb_2～Ⅱa_2期宫颈癌患者的疗效及生存分析
|
摘要
目的分析术前子宫动脉化疗栓塞治疗Ⅰb2～Ⅱa2期宫颈癌患者的疗效、安全性及生存情况。方法回顾性分析90例Ⅰb2～Ⅱa2期宫颈癌患者的病历资料,根据治疗方法不同将患者分为观察组和对照组,每组45例。对照组患者接受术前辅助放疗,观察组患者在对照组的基础上实施术前子宫动脉化疗栓塞。对两组患者术前辅助治疗达到手术治疗标准者,实施宫颈癌根治术。比较两组患者术前辅助治疗的疗效及不良反应发生情况,比较两组接受手术患者的手术指标和病理结果,并对其生存情况进行分析。结果观察组患者术前辅助治疗的疗效优于对照组(P﹤0.05)。观察组和对照组患者的骨髓抑制发生情况比较,差异无统计学意义(P﹥0.05)。观察组患者的手术时间明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。观察组患者的宫颈长度短于对照组,肌层浸润和脉管癌栓所占比例均低于对照组,差异均有统计学意义(P﹤0.05)。随访结果显示,观察组患者的生存情况优于对照组(P﹤0.05)。结论术前子宫动脉化疗栓塞治疗Ⅰb2～Ⅱa2期宫颈癌患者具有良好的近期和远期疗效,且安全性较好。
Objective To analyze the efficacy, safety and survival of preoperative uterine artery chemoembolization in patients with stage Ib2-IIa2 cervical cancer. Method The medical profiles of 90 patients with stage Ib2-IIa2 cervical cancer were retrospectively analyzed. According to the different treatment methods, they were divided into study group and control group, with 45 cases in each. The control group received preoperative adjuvant radiotherapy, and the study group was treated with uterine artery chemoembolization on the basis of adjuvant radiotherapy. Radical hysterectomy was performed for patients who met the requirements of surgery after adjuvant radiotherapy. The curative effects and adverse reactions of the two groups after preoperative adjuvant radiotherapy were evaluated, and so did the operative conditions and pathological results, and lastly the survival of these patients were analyzed. Result Better clinical efficacy were observed in study group than in control group after preoperative adjuvant radiotherapy(P<0.05). There was no significant difference in bone marrow suppression between the study group and the control group(P>0.05). The operative time in study group was shorter, and the volume of intraoperative blood loss was less than that of the control group, and the differences were statistically significant(P<0.01). The mean cervical length in study group was less than that in the control group, with lower ratio of muscular infiltration and vascular tumor thrombus in study group compared with control group,showing statistically significant differences(P<0.05). The follow-up results indicated that the survival of the patients in study group was markedly better than that in the control group(P<0.05). Conclusion Preoperative uterine artery chemoembolization has fairly good short-term and long-term efficacy and safety for patients with stage Ib2-IIa2 cervical cancer.
Objective To analyze the efficacy, safety and survival of preoperative uterine artery chemoembolization in patients with stage Ib2-IIa2 cervical cancer. Method The medical profiles of 90 patients with stage Ib2-IIa2 cervical cancer were retrospectively analyzed. According to the different treatment methods, they were divided into study group and control group, with 45 cases in each. The control group received preoperative adjuvant radiotherapy, and the study group was treated with uterine artery chemoembolization on the basis of adjuvant radiotherapy. Radical hysterectomy was performed for patients who met the requirements of surgery after adjuvant radiotherapy. The curative effects and adverse reactions of the two groups after preoperative adjuvant radiotherapy were evaluated, and so did the operative conditions and pathological results, and lastly the survival of these patients were analyzed. Result Better clinical efficacy were observed in study group than in control group after preoperative adjuvant radiotherapy(P<0.05). There was no significant difference in bone marrow suppression between the study group and the control group(P>0.05). The operative time in study group was shorter, and the volume of intraoperative blood loss was less than that of the control group, and the differences were statistically significant(P<0.01). The mean cervical length in study group was less than that in the control group, with lower ratio of muscular infiltration and vascular tumor thrombus in study group compared with control group,showing statistically significant differences(P<0.05). The follow-up results indicated that the survival of the patients in study group was markedly better than that in the control group(P<0.05). Conclusion Preoperative uterine artery chemoembolization has fairly good short-term and long-term efficacy and safety for patients with stage Ib2-IIa2 cervical cancer.
引文
[1]王庆西.老年宫颈癌组织中人乳头状瘤病毒16-E6、p53mRNA表达及其与放疗敏感性的相关性[J].中国老年学杂志,2017,37(22):5622-5624.
[2]赵先文,平翠香,荆结线,等.宫颈癌患者CEA和SCC-Ag血清水平联合检测的临床应用价值[J].现代肿瘤医学,2013,21(10):2316-2318.
[3]朱滔,朱笕青,高永良.宫颈癌诊治现状与进展[J].中国肿瘤,2013,22(12):970-974.
[4]Haie-Meder C,Morice P,Castiglione M,等.欧洲肿瘤内科协会对宫颈癌的诊断、治疗和随访所制定的临床实践指南[J].国际妇产科学杂志,2011,38(1):82-84.
[5]Atkinson TM,Ryan SJ,Bennett AV,et al.The association between clinician-based common terminology criteria for adverse events(CTCAE)and patient-reported outcomes(PRO):a systematic review[J].Support Care Cancer,2016,24(8):3669-3676.
[6]Eisenhauera EA,Therasseb P,Bogaerts J,et al.New response evaluation criteria in solid tumours:revised RECISTguideline(version1.1)[J].Eur J Cancer,2009,45(2):228-247.
[7]吴利荣,韩阳,谭明,等.髂内动脉灌注化疗与子宫动脉化疗栓塞晚期宫颈癌的临床疗效对比[J].实用癌症杂志,2018,33(2):336-339.
[8]杨永昆,许万松.调强放疗联合腔内近距离放疗在晚期宫颈癌中的疗效评价[J].医学综述,2018,24(17):3525-3528.
[9]曹蕾,加静,吴东,等.髂内动脉栓塞联合灌注化疗在进展期宫颈癌治疗中的疗效及对血清VEGF的影响[J].广西医科大学学报,2017,34(10):1460-1463.
[10]彭玲,廖丽川.介入化疗加栓塞术与新辅助化疗全身静脉化疗在宫颈癌根治性手术患者中的应用效果比较[J].癌症进展,2017,15(7):784-786.
[11]王华,郭旭.高强度聚焦超声联合介入栓塞化疗对晚期宫颈癌病灶生长及细胞侵袭的影响[J].海南医学院学报,2017,23(8):1157-1160.
[12]陈泽奎.放疗联合子宫动脉介入栓塞化疗术治疗宫颈癌的效果观察[J].实用癌症杂志,2017,32(5):802-804.
[13]张晓英,王飞鹏,张新选,等.子宫动脉栓塞灌注化疗对宫颈癌的局部微淋巴管密度和血管内皮生长因子的影响[J].广西医科大学学报,2017,34(10):1489-1492.
[14]赵青莲,邓丽霞,张浩,等.宫颈癌术后补充放疗患者预置输尿管支架改善泌尿系统并发症的临床研究[J].天津医药,2018,46(2):171-174.
[15]杨学刚,许国辉,吴戈,等.子宫动脉化疗栓塞治疗局部晚期宫颈癌[J].中华放射学杂志,2013,47(8):735-738.
[16]易启华.局部晚期及晚期宫颈癌腹主动脉旁淋巴结手术评估的价值[J].实用妇产科杂志,2018,34(4):261-264.
[17]孙静莉.术前选择性子宫动脉化疗栓塞用于宫颈癌的临床疗效分析[J].实用癌症杂志,2018,33(3):493-496.
[18]刘瑶,孔为民.宫颈腺癌治疗进展[J].中国生育健康杂志,2017,28(1):91-93.
[2]赵先文,平翠香,荆结线,等.宫颈癌患者CEA和SCC-Ag血清水平联合检测的临床应用价值[J].现代肿瘤医学,2013,21(10):2316-2318.
[3]朱滔,朱笕青,高永良.宫颈癌诊治现状与进展[J].中国肿瘤,2013,22(12):970-974.
[4]Haie-Meder C,Morice P,Castiglione M,等.欧洲肿瘤内科协会对宫颈癌的诊断、治疗和随访所制定的临床实践指南[J].国际妇产科学杂志,2011,38(1):82-84.
[5]Atkinson TM,Ryan SJ,Bennett AV,et al.The association between clinician-based common terminology criteria for adverse events(CTCAE)and patient-reported outcomes(PRO):a systematic review[J].Support Care Cancer,2016,24(8):3669-3676.
[6]Eisenhauera EA,Therasseb P,Bogaerts J,et al.New response evaluation criteria in solid tumours:revised RECISTguideline(version1.1)[J].Eur J Cancer,2009,45(2):228-247.
[7]吴利荣,韩阳,谭明,等.髂内动脉灌注化疗与子宫动脉化疗栓塞晚期宫颈癌的临床疗效对比[J].实用癌症杂志,2018,33(2):336-339.
[8]杨永昆,许万松.调强放疗联合腔内近距离放疗在晚期宫颈癌中的疗效评价[J].医学综述,2018,24(17):3525-3528.
[9]曹蕾,加静,吴东,等.髂内动脉栓塞联合灌注化疗在进展期宫颈癌治疗中的疗效及对血清VEGF的影响[J].广西医科大学学报,2017,34(10):1460-1463.
[10]彭玲,廖丽川.介入化疗加栓塞术与新辅助化疗全身静脉化疗在宫颈癌根治性手术患者中的应用效果比较[J].癌症进展,2017,15(7):784-786.
[11]王华,郭旭.高强度聚焦超声联合介入栓塞化疗对晚期宫颈癌病灶生长及细胞侵袭的影响[J].海南医学院学报,2017,23(8):1157-1160.
[12]陈泽奎.放疗联合子宫动脉介入栓塞化疗术治疗宫颈癌的效果观察[J].实用癌症杂志,2017,32(5):802-804.
[13]张晓英,王飞鹏,张新选,等.子宫动脉栓塞灌注化疗对宫颈癌的局部微淋巴管密度和血管内皮生长因子的影响[J].广西医科大学学报,2017,34(10):1489-1492.
[14]赵青莲,邓丽霞,张浩,等.宫颈癌术后补充放疗患者预置输尿管支架改善泌尿系统并发症的临床研究[J].天津医药,2018,46(2):171-174.
[15]杨学刚,许国辉,吴戈,等.子宫动脉化疗栓塞治疗局部晚期宫颈癌[J].中华放射学杂志,2013,47(8):735-738.
[16]易启华.局部晚期及晚期宫颈癌腹主动脉旁淋巴结手术评估的价值[J].实用妇产科杂志,2018,34(4):261-264.
[17]孙静莉.术前选择性子宫动脉化疗栓塞用于宫颈癌的临床疗效分析[J].实用癌症杂志,2018,33(3):493-496.
[18]刘瑶,孔为民.宫颈腺癌治疗进展[J].中国生育健康杂志,2017,28(1):91-93.