| Objective:To investigate the efficacy and clinical significance of interventional chemoembolization in the treatment of stage I B2~II B cervical cancer.Methods:The clinical and pathological data of 158 patients with stage I B2~II B cervical cancer admitted to the First Affiliated Hospital of Medical College of Shihezi University from January 1,2005 to December 31,2015 were retrospectively analyzed.The research is divided into two parts,the first part: patients with stage I B2~II A were divided into two groups according to the initial treatment methods: direct operation group(group1)and interventional chemoembolization plus surgery group(group2).The intraoperative conditions,intraoperative complications,post-operative pathology,post-operative adjuvant treatment and survival rate were compared between the two groups.The second part: patients with stage II B were divided into concurrent chemoradiotherapy(group A),interventional chemoembolization plus surgery group(group B)and radiotherapy alone group(group C)were used to analyze and compare the survival rate and treatment-related adverse reactions.Meanwhile,the quality of life of these patients was investigated.Results:(1)The first part: interventional chemoembolization at all stages can achieve good short-term effect.The operation time of group 2was shorter than that of group 1(2.88±0.22 h vs 3.11±0.21h),the intraoperative bleeding volume of group 2was less than that of group 1(104.55±14.60 ml vs 140.22±24.99ml),the difference was significant(P<0.05);The rates of pelvic lymph node metastasis(47.83% vs 24.24%),parametrial infiltration(32.61% vs 15.15%),tumor diameter>4cm(47.83% vs 21.21%)and deep interstitial infiltration≥1/2 were higher in group 1 than in group 2(43.48% vs 18.18%),The difference was significant(P < 0.05).The positive rate of incision margin(4.35% vs 0.00%)and lymphatic vessel infiltration rate(21.74% vs 15.15%)were not significantly different between the two groups(P>0.05).The proportion of adjuvant treatment in group 1 was higher than that in group 2(86.96% vs 57.58%).there was significant difference(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).(2)The second part: there was no significant difference in the overall survival rate(OS)and disease-free survival rate(DFS)between the two groups(P > 0.05).The 3-year OS and DFS of group A were 94.4% and 88.5%,respectively;the 3-year OS and DFS of group B were 92.1% and 88.1% respectively;the 3-year OS and DFS of group C were 72.2% and 66.7%,respectively.The survival rate between the two groups is similar(P>0.05).The 5-year OS(88.5%)and 5-year DFS(79.7%)of group A were higher than those of group C in 5-year OS(58.2%)and 5-year DFS(42.9%),P<0.05.the 5-year OS and DFS of group A were higher than those of group B in 5-year OS(82.3%)and DFS(74.2%),but in the aspect of statistical significant between group A and B is similar(P>0.05).the 5-year OS and DFS of group B were higher than those of group C,P<0.05.Group A,group B and group C had no significant difference in physical function,cognitive function,social function,role function and emotional function,P>0.05.In the symptoms of nausea and vomiting in group A were more severe than those in group B and C,P<0.05.In the symptoms of constipation and diarrhea in group A were more severe than those in group B and C,and those in group C were more severe than those in group B,P<0.05.In terms of quality of sexual life,group B was higher than group A and group C,P<0.05;in terms of urinary symptoms,group B was heavier than group A and group C,P<0.05.Conclusion: Interventional chemoembolization has a remarkable short-term effect on cervical cancer,which improve the quality of life of some patients.It has certain significance for individualized treatment of cervical cancer patients,but it does not significantly improve the survival and prognosis,and has the risk of covering up the pathological factors after operation.Care should be taken when choosing therapy method,so it can not be used as a routine treatment. |
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