Application observation of neoadjuvant chemotherapy in radical resection of cervical cancer of stage IB2-IIB

Abstract

Objective To investigate the efficacy of neoadjuvant chemotherapy combined with radical resection of cervical cancer in the treatment of stage IB2-ⅡB cervical cancer. Methods According to the treatment plan from October 2012 to October 2016 in the People′s Hospital of Luohu District of Shenzhen in 80 cases of stage IB2- II B cervical cancer patients were divided into observation group(n=43) and control group(n=37), the observation group was treated with neoadjuvant chemotherapy combined with radical surgery for cervical cancer, patients in the control group directly treated for radical resection of cervical cancer.Chemotherapy effect, operation time, intraoperative blood loss, postoperative pathological risk factor differences of two groups of patients were compared. Results (1)Evaluated the curative effect of neoadjuvant chemotherapy, squamous cell carcinoma group complete remission(CR) 4 cases, partial remission(PR) 22 cases, stable disease(SD), 6 cases of disease progression(PD) in 0 cases, in adenocarcinoma group CR 1 cases, PR 3 cases, SD 5 cases, PD 2 cases of squamous cell carcinoma group adjuvant chemotherapy was significantly better than that of adenocarcinoma group, the difference was statistically significant(z=2.4968, P=0.0063). (2)The operation time((215±57) min) and intraoperative blood loss((682±145) ml) in the observation group were significantly lower than those in the control group(((259±62) min, (758±193) ml)), the difference was statistically significant(t=3.8780, 2.2528, P=0.0002, 0.0263). (3)The two groups of patients with ureteral fistula(P=0.5039), vesicovaginal fistula(P=0.3639), wound healing(P=0.5182), lower extremity deep venous thrombosis(P=0.4818) complications had no significant difference.(4)The positive rate of the observation group of lymph nodes(χ2=8.2005, P=0.0000), parametrial infiltration rate(χ2=8.1553, P=0.0000) was significantly lower than the control group, the difference was statistically significant.Two groups of patients with deep myometrial invasion rate(χ2=0.0991, P=0.7516), the incidence of cancer embolus(χ2=0.0130, P=0.9176) compared to no statistical significance. Conclusion The effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma is better than that of adenocarcinoma.Compared with the direct for radical resection of cervical cancer, neoadjuvant chemotherapy combined with radical resection of cervical cancer patients for the treatment of stage IB2-ⅡB cervical cancer, operation time and blood loss are lower, node positive and parametrial invasion and postoperative pathologic risk factors in lymph node also can get better effect. Key words: Neoadjuvant chemotherapy; Radical resection of cervical cancer; IB2-ⅡB stage; Cervical carcinoma; Squamous cell carcinoma; Adenocarcinoma