Discussion On The Short-term Clinical Curative Effects Of The Preoperative Treatments Of â… b-â…¡b Cervical Cancer

Objective To discuss the short-term clinical curative effects of the preoperative treatments of Ib-IIb cervical cancer.Methods Retrospective study of 118 subjects with Ib-IIb cervical cancer in our hospital between 2001 January and 2010 October.According to treatment,they were divided into four gloups , arterial interventional chemotherapy followed by surgery,intravenous chemotherapy followed by surgery,radiotherpy followed by surgery and radical surgery。The first three groups belonged to groups of preoperative treatment. In which,groups of preoperative interventional chemotherapy and preoperative chemotherapy were parts of neoadjuvant chemotherapy(NAC). We compared the rates of adverse pathological factors detected and complications after surgery between groups of preoperative treatment and radical surgery. The regression rate of tumor,operation time,volume of blood loss,rates of adverse pathological factors detected and side effects between groups of preoperative treatment were also discussed and compared.Results Adverse pathologic factors and high-risk factors are definitely higher in group of radical surgery than in groups of preoperative treatment(the rate of adverse pathologic factors 96.67% VS 62.79% , high-risk factors 63.33% VS 32.56% ,P<0.05),while the differences of volume of blood loss,the rate of complications between groups of preoperative treatment and radical surgery showed no significance.The rate of side effects in group of radiotherapy is higher than that in groups of neoadjuvant chemotherapy(45.16% VS 12.5%,16.00%),though the regression situation of tumor,operation time,volume of blood loss,rates of adverse pathological factors detected after surgery showed no difference in three groups. As to Ib,IIa locally advanced cervical cancer, though the difference of regress rate of tumor between NAC and radiotherpy group ( 82.75% vs 75.00%)showed no significance, in NAC,the rate of adverse pathological factors was 44.83%, lower than 86.67% in group of preoperative radiotherapy, the difference was statistically significant (P <0.05). As to those cases of Ib-lIb cervical cancer which failed in regression of tumor after preoperative treatment, the rate of adverse pathological factors was 100.00% in group of preoperative radiotherapy, 69.23% in group of preoperative interventional chemotherapy, 40.00% in group of preoperative intravenous chemotherapy, the rate in group of preoperative radiotherapy was significantly higher than that in two other groups and the difference was significant (P <0.05).The regression rate of tumor,volume of blood loss,operation time and the rate of complications did not differ significantly between group of preoperative interventional chemotherapy and preoperative intravenous chemotherapy.Conclusion Preoperative treatment can reduce size of tumor in Ib-IIb cervical cancer, which is beneficial to surgery, it can also reduce the incidence of adverse pathology factors,and improve the quality of life.Preoperative radiotherapy and neoadjuvant chemotherapy before surgery had no differences in the short-term clinical curative effects of Ib-IIb cervical cancer, but neoadjuvant chemotherapy reduce incidence of adverse reactions. As to Ib, IIa locally advanced cervical cancer, neoadjuvant chemotherapy and preoperative radiotherapy have similarly regression of tumor;however,neoadjuvant chemotherapy,more reduce the incidence of adverse pathological factors.As to those cases of Ib-lIb cervical cancer which failed in regression of tumor after preoperative treatment, neoadjuvant chemotherapy, especially intravenous chemotherapy can reduce the incidence of adverse pathological factors, compared to the preoperative radiotherapy. Preoperative intravenous chemotherapy is simple,convenient, economical, and it requires no special equipment and has more clinical applications.