CAJ | 학술논문

目的：对比研究静脉化疗和介入性动脉化疗结合手术2种方式治疗局部晚期宫颈癌的疗效。方法按照初始时接受治疗方法的不同，将140例局部晚期（Ib2～Ⅱb 期）宫颈癌患者分为实验组（介入性子宫动脉化疗＋手术）和对照组（静脉化疗＋手术）2组，各70例。观察治疗后患者的近期总有效率、治疗前后肿瘤直径变化情况、根治手术率、3年和5年生存率（OS）及无进展生存率（PFS）、并发症、病理危险因素（子宫宫旁浸润率、淋巴结转移率）发生情况。结果2组患者近期总体有效率均较高，但差异无统计学意义；实验组治疗后瘤体直径变小比对照组的更明显，其获得根治性手术机会比对照组高，相应的淋巴结转移率、子宫宫旁浸润率低于对照组；2组的3年期的生存率、无进展生存率无差异，但5年期生存率、无进展生存率实验组比对照组高。结论动脉介入途径新辅助化疗治疗局部晚期宫颈癌手术切净率、5年生存率均优于静脉化疗，是一种安全有效的治疗手段。
목적：대비연구정맥화료화개입성동맥화료결합수술2충방식치료국부만기궁경암적료효。방법안조초시시접수치료방법적불동，장140례국부만기（Ib2～Ⅱb 기）궁경암환자분위실험조（개입성자궁동맥화료＋수술）화대조조（정맥화료＋수술）2조，각70례。관찰치료후환자적근기총유효솔、치료전후종류직경변화정황、근치수술솔、3년화5년생존솔（OS）급무진전생존솔（PFS）、병발증、병리위험인소（자궁궁방침윤솔、림파결전이솔）발생정황。결과2조환자근기총체유효솔균교고，단차이무통계학의의；실험조치료후류체직경변소비대조조적경명현，기획득근치성수술궤회비대조조고，상응적림파결전이솔、자궁궁방침윤솔저우대조조；2조적3년기적생존솔、무진전생존솔무차이，단5년기생존솔、무진전생존솔실험조비대조조고。결론동맥개입도경신보조화료치료국부만기궁경암수술절정솔、5년생존솔균우우정맥화료，시일충안전유효적치료수단。
Objective To compare the efficacy and safety of intravenous chemotherapy plus operation and interventional arterial chemotherapy plus operation in treatment of patients with local-ly advanced cervical carcinoma (phases Ib2~IIb).Methods 140 patients with locally advanced cervical carcinoma (phases Ib2~IIb)were divided into experimental group (uterine artery interven-tional chemotherapy plus surgery)and control group (venous chemotherapy plus surgery)according to different initial therapeutic methods,70 cases in each group.Short-term efficacy,tumor diameter changes before and after treatment,rate of radical operation,3 and 5 years overall survival (OS), progression-free survival (PFS),complications as well as pathological risk factors (rates of para-u-terine invasion and lymph node metastasis)were observed.Results Short-term efficacy improved in both groups.The decreased tumor diameter in experimental group was significantly greater than control group,and the probability rate of patients with radical operation was significantly larger than the control group.Corresponding rates of para-uterine invasion and lymph node metastasis in the ex-perimental group were significantly lower than the control group.There were no significant differ-ences of 3 years OS and PFS between two groups,and the 5 years OS and PFS in the experimental group were higher than the control group.Conclusion For patients with locally advanced cervical carcinoma,neo-adjuvant chemotherapy with artery interventional therapy is better than intravenous chemotherapy in aspects of surgical resection rate and 5 years OS,so it is a safe and effective thera-peutic method.