CAJ | 학술논문

目的：对比分析两种不同术前化疗方案PVB（博来霉素＋长春新碱＋顺铂）和FP（5-氟尿嘧啶＋顺铂）联合术前放疗对于宫颈癌IIb期的临床疗效、手术影响、放化疗不良反应及远期复发率、生存率影响。方法：采取随机数字表法将2010年3月至2013年5月我科收治的宫颈癌IIb期100例分为两组，实验组采取PVB方案术前同步放化疗，对照组采取FP方案术前同步放化疗。对比两组患者放化疗前后宫颈肿块体积，两组患者放化疗后的骨髓抑制和胃肠道反应发生情况，两组患者手术时间及术中出血量，两组患者术后病理提示的宫旁浸润、阴道残端浸润、深肌层浸润、宫颈间质浸润发生率，两组患者的3年生存率及复发率。结果：两组患者在放化疗后的宫颈肿块体积均显著下降，P＜0.01；但实验组放化疗后肿块体积显著小于对照组，P＜0.01；对照组放化疗后的不良反应与实验组无显著差异，P＞0.05；实验组的手术时间和术中出血量显著低于对照组，P＜0.05；术后病理实验组的浸润转移程度显著低于对照组，P＜0.05；实验组的术后3年生存率显著高于对照组，P＜0.05；实验组术后3年复发率显著低于对照组，P＜0.05。结论：PVB方案较FP方案而言，对于患者术前的放化疗更加有效，且更加利于手术切除，减少肿瘤浸润与转移程度，提高患者术后生存率，但两者毒副反应无显著差异。
목적：대비분석량충불동술전화료방안PVB（박래매소＋장춘신감＋순박）화FP（5-불뇨밀정＋순박）연합술전방료대우궁경암IIb기적림상료효、수술영향、방화료불량반응급원기복발솔、생존솔영향。방법：채취수궤수자표법장2010년3월지2013년5월아과수치적궁경암IIb기100례분위량조，실험조채취PVB방안술전동보방화료，대조조채취FP방안술전동보방화료。대비량조환자방화료전후궁경종괴체적，량조환자방화료후적골수억제화위장도반응발생정황，량조환자수술시간급술중출혈량，량조환자술후병리제시적궁방침윤、음도잔단침윤、심기층침윤、궁경간질침윤발생솔，량조환자적3년생존솔급복발솔。결과：량조환자재방화료후적궁경종괴체적균현저하강，P＜0.01；단실험조방화료후종괴체적현저소우대조조，P＜0.01；대조조방화료후적불량반응여실험조무현저차이，P＞0.05；실험조적수술시간화술중출혈량현저저우대조조，P＜0.05；술후병리실험조적침윤전이정도현저저우대조조，P＜0.05；실험조적술후3년생존솔현저고우대조조，P＜0.05；실험조술후3년복발솔현저저우대조조，P＜0.05。결론：PVB방안교FP방안이언，대우환자술전적방화료경가유효，차경가리우수술절제，감소종류침윤여전이정도，제고환자술후생존솔，단량자독부반응무현저차이。
To compare and analyze the clinical efficacy,surgical effects,side effects and long-term recurrence and survival rate of two different preoperative radiotherapy and chemotherapy programs:PVB (bleomycin,vincristine,cisplatin)and FP (5 -fluorouracil and cisplatin)for patients with Phase IIb cervical cancer.Methods:100 patients with Phase IIb cervical cancer in our department between March 2010 and May 2013 were randomly divided into two groups.The experimental group was given preoperative radiotherapy with PVB, while the control group was given preoperative radiotherapy with FP.To compare the cervical tumor volume of two groups before and after therapy,myelosuppression and gastrointestinal reactions situation,the operative time and blood loss,postoperative pathology such as the parametrial infiltration,vaginal stump infiltration,deep myometrial invasion,cervical stromal invasion,the incidence of 3 -year survival and recurrence in both groups of patients. Results:The cervical tumor volume of two groups was obviously smaller than that before the therapy,P<0.01.But the cervical tumor volume of the experimental group was significantly smaller than that of the control group,P<0.01.There was no significant difference in the adverse reactions between the two groups after the therapy,P>0.05 .The degree of invasion and the 3-year recurrence rate of the experimental group were lower than those of the control group,P<0.05.The survival rate of the experimental group was higher than that of the control group,P<0.05.Conclusions:PVB program is more effective in preoperative radiotherapy and chemotherapy,and more con-ducive to surgery in reducing the extent of tumor invasion and metastasis,improving survival rates,than FP pro-grams,but there is no significant difference in toxicity.