Cheng Xiao-dong, Lü Wei-guo, Ye Feng, Chen Huai-zeng, Xie Xing
Department of Gynecological Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.
Zhonghua Fu Chan Ke Za Zhi. 2006 Feb;41(2):95-8.
To investigate the effect of neoadjuvant chemotherapy on locally advanced cervical cancer, the factors affecting outcome of chemotherapy and the long-term survival rate in the patients.
A total of 64 patients with stageIb2-IIb of locally advanced cervical cancers treated with neoadjuvant chemotherapy between June 1999 and October 2004 in Women's Hospital, School of Medicine, Zhejiang University were retrospectively analysed. The effect of chemotherapy, as well as survival rate was evaluated. The related factors of effect, including age, histology, clinical stage, grade of differentiation, initial tumor size, chemotherapy regimens, number of courses were analysed.
Overall effective rate of neoadjuvant chemotherapy was 80%. The effective rate was associated with histology. The patients with squamous cell cancer had significantly higher 5-year survival rate than those with adenocarcinoma (82% vs 6/9, P < 0.05). The rates of positive pelvic lymph node metastasis and parametrial invasion were significantly higher in complete or partial response patients than those in stable patients (P < 0.05). The overall 5-year survival rate was 89%. The 5-year survival rate in complete or partial response group was 100%, in stable disease group was 46% (P < 0.05). The 3, 5-year disease-free survival rate in complete or partial response group was 95% and 83%, respectively, while in stable disease group was 33% and 0, respectively. The disease-free survival rates in complete or partial response group were higher than those of stable disease group (P < 0.05).
The clinical response to neoadjuvant chemotherapy is related to histology. The patients who have good response to chemotherapy should choose surgery. Chemotherapy can decrease the high risk factors of pathology in complete or partial response patients. Neoadjuvant chemotherapy for locally advanced cervical cancer patients seems to improve the long-term survival rate.
探讨新辅助化疗对局部晚期宫颈癌的疗效、影响化疗效果的因素以及患者的长期生存率。
回顾性分析1999年6月至2004年10月在浙江大学医学院附属妇产科医院接受新辅助化疗的64例Ib2-IIb期局部晚期宫颈癌患者。评估化疗效果及生存率，并分析影响疗效的相关因素，包括年龄、组织学类型、临床分期、分化程度、初始肿瘤大小、化疗方案、疗程数等。
新辅助化疗的总有效率为80%。有效率与组织学类型有关。鳞状细胞癌患者的5年生存率显著高于腺癌患者（82% 对6/9，P < 0.05）。完全或部分缓解患者的盆腔淋巴结转移阳性率和宫旁浸润率显著高于病情稳定患者（P < 0.05）。总5年生存率为89%。完全或部分缓解组的5年生存率为100%，病情稳定组为46%（P < 0.05）。完全或部分缓解组的3年、5年无病生存率分别为95%和83%，而病情稳定组分别为33%和0。完全或部分缓解组的无病生存率高于病情稳定组（P < 0.05）。
新辅助化疗的临床反应与组织学类型有关。对化疗反应良好的患者应选择手术。化疗可降低完全或部分缓解患者的病理高危因素。局部晚期宫颈癌患者的新辅助化疗似乎可提高长期生存率。
