Clinical Retrospective Analysis Of Neoadjuvant Chemotherapy For Locally Advanced Uterine Cervical Carcinoma

Objective:The purpose of this study is to understand the effect of neoadjuvant chemotherapy for advanced cervical cancer, the impact on the pathological staging of adverse prognostic factors (such as vaginal surgical margins, parametrial infiltration, vascular invasion, lymph node-positive rate, etc.), and adverse reactions caused by chemotherapy, to investigate its clinical significance.Methods:I collected a total of 100 patients with advanced cervical cancer, 30 cases with preoperative neoadjuvant chemotherapy,70 cases with direct surgical patients as the control group in department of Obstetrics and Gynecology of Jilin University First Hospital during January 2007～January 2011. With descriptive, retrospective comparative methods of analysis, I applied EXCEL software to build database and used chart and SPSS 17.0χ2 test to statistically analyze clinical data, to analysis the clinical features of preoperative neoadjuvant chemotherapy group and direct surgery group, to analysis the chemotherapy response of different stage, tumor type, pathological grade of cervical cancer, to compare the pathology results between preoperative neoadjuvant chemotherapy group and direct surgery group, to analysis of the chemotherapy response, the conditions of pathological downstaging, poor prognostic factors, and adverse reactions between two methods of neoadjuvant chemotherapy.Results:(1) The composition ratio ofⅠb2,Ⅱa,Ⅱb period cervical cancer patients with different methods of neoadjuvant chemotherapy was statistically significant. Overall, patients with Chemotherapy through the femoral artery were much severely illed than patients with postoperative intravenous chemotherapy.The age of cervical cancer patients undergoing neoadjuvant chemotherapy before operation and undergoing direct surgery was not statistically significant. (2) The effect of neoadjuvant chemotherapy toⅠb2,Ⅱa,Ⅱb period cervical cancer patients has no difference. The result is also to the different pathological types and tumor grade of locally advanced cervical cancer. (3) Chemotherapy through the femoral artery and intravenous could effectively reduce the maximum diameter of the tumor,the former had better effect. The vascular invasion rate of patients undergoing the chemotherapy through the femoral artery is lower than the patients undergoing the chemotherapy through the vain.The cutting edge situation of vagina, parametrium and lymph node-positive rate case have no significant difference between two groups. (4) The incidence of myelosuppression, hair loss and digestive system adverse reactions of chemotherapy through the femoral artery is lower than chemotherapy through intravenous. The occurrence of liver damage and febrile adverse reactions has no difference between the two groups. (5) The vessel invasion and lymph node-positive rate of preoperative neoadjuvant chemotherapy group rate is less than the direct surgery group. Conclusion:(1) Neoadjuvant chemotherapy has effect to cervical cancer patients of different period, different pathological types and tumor grade.(2) Chemotherapy through the femoral artery and intravenous could effectively reduce the maximum diameter of the tumor, the former had better effect. The vascular invasion rate of patients undergoing the chemotherapy through the femoral artery is lower than the patients undergoing the chemotherapy through the vain.(3) The vessel invasion and lymph node-positive rate of preoperative neoadjuvant chemotherapy group rate is less than the direct surgery group.(4) The incidence of myelosuppression, hair loss and digestive system adverse reactions of chemotherapy through the femoral artery is lower than chemotherapy through intravenous.