The30Patients Analysis About Neoadjuvant Chemotherapy In Cervical Carcinoma

Cervical cancer is the most common gynecological malignant tumor.Due towidespread application of cervical cytology screening in recent40years,cervical canerand its precancerous lesions can be diagnosed and treated early.So its the morbidity andmortality have reduced remarkably.But in recent years the incidence of cervical cancerhave a younger trend.It still seriously impacts on women’s health and quality oflife.Therefore cervical cancer is one of women’s health problems which catch theattention of the global.Radical surgery and radiotherapy are the main treatment methodsfor cervical cancer,early patients with surgical treatment is first given, most middle-latepatients choose radiotherapy.Although the technology,techniques and equipments ofsurgery and radiotherapy have been improved,,the treatment effect of cervical cancerdon’t fundamental change,the five years survival rate is not obviously improved.So itpresents a challenge to the traditional treatment strategies.Neoadjuvant chemotherapy(NACT)is put forward for the first time by Feri in1982.As the new chemotherapydrugs,chemotherapy and chemotherapy approaches appear constantly,NACT mademany patients who originally can’t surgery obtained an precious opportunity ofsurgery,while reducing the effect of pathological risk factors on the prognosis.Not onlyprolonged the survival time of patients,but also it improve the quality of life.So,the roleof NACT on cervical cancer treatment is more and more widely attention.Objective:To analysis the short-term curative effect and clinical significance ofneoadjuvant chemotherapy on cervical cancer in stage IB2-IIB.Methods:30cervical cancer patients in stages IB2-IIB in the military general hospital ofBeijing PLA who underwent operation after arterial catheter chemotherapy withpaclitaxel and carboplatin from2009.9to2012.11consisted study group.All of themhad complete clinical and pathological data,and no obvious contraindications ofchemotherapy.Every patient was evaluated after2weeks when the drugs were stoppedand had1or2chemotherapy.The interval of chemotherapy is3weeks.They were all given Radical hysterectomy and Pelvic lymph node dissection through laparoscope2weeks after the last NACT if they conformed to the operation conditions and had nocontraindications.Young patients kept normal ovaries and were performed with ovarytransposition.30patients in stage IB1and IIA who only received radical surgery in thesame time were served as the control group.The tumor size, improvement of utero-tissue infiltration and adverse effects ofNACT were reviewed.Analyze the related factors that influence the short-term effect ofneoadjuvant chemotherapy.Compare two groups of the operation time,intraoperativeblood loss and the incidence of postoperative complications.And we also compare twogroups of the incidence of pelvic lymph node metastasis,cervical deep muscleinfiltration,invasion,utero-tissue infiltration,vascular space involvement and tumorpositive rate of the vaginal incisal margin,and so on and so forth.Results:The effective rate of NACT was86.7%,and there were5complete responsecases(16.7%) and21partial response cases(70%).The therapeutic effect has somethingto do with pathological pattern（P<0.05）.The therapeutic effect of squamous carcinomawas much better than that of adenocarcinoma（P<0.05),but not associated with clinicalstaging or pathological grade(P>0.05). The postoperative pathology reports showed thatthe incidence rate of pelvic lymph node metastasis(16.7%),cervical deep muscleinfiltration(16.7%),utero-tissue infiltration (0%), vascular space involvement (6.7%)andtumor positive rate of the vaginal incisal margin(0%) in the study group were lower thanthose in the control group(40%、40%、20%、30%、23.3%). The differences werestatistically significant (P <0.05).There was no significant difference between the twogroups in the operation time,intraoperative blood loss and postoperativecomplications(P>0.05).And there is no un-tolerance adverse reaction in the studygroup.Conclusions:For the cervical cancer patients with stage IB2-IIB,preoperativeneoadjuvant chemotherapy is effective,feasible and safe.NACT can shrink significantlythe cervical cancer,reduce utero-tissue infiltration and degrade clinical staging,thatcreate a chance for radical surgery.At the same time preoperative NACT did not occurserious adverse reaction and increase the risk of surgery and postoperativecomplications,and it reduced the effect of pathological risk factors on the prognosis.Itsshort-term effect has gat the sufficient affirmation.Therefore,as an adjuvant therapy forcervical cancer before surgery,NACT has a good application prospect and value.