The Clinical Case-control Study Of Cervical Cancer Applying Neoadjuvant Chemotherapy

ObjectiveTo explore clinical effect of applying TP program of combination between paclitaxel liposome and oxaliplatin, between docetaxel and oxaliplatin into neoadjuvant chemotherapy of cervical cancer. MethodsSelected 117 cervical cancer patients treated in our hospital from September 2012 to December 2015 as object of study. Among them, 35 patients are Ib2 and IIa2 stage and 82 patients are Ib2 and IIa2 stage. 35 patients in Ib2 and IIa2 stage are listed in reference group A, after routine preoperative examination, this group is directly implemented radical hysterectomy + pelvic lymphadenectomy. 82 patients in Ib2 and IIa2 stage are listed in comparison group, TP1 group and TP2 group respectively includes 41 patients, the comparison group is first implemented neoadjuvant chemotherapy for 2 courses, then implemented radical hysterectomy + pelvic lymphadenectomy. TP1 group is implemented neoadjuvant chemotherapy of combination between paclitaxel liposome and oxaliplatin; TP2 group is implemented neoadjuvant chemotherapy of combination between docetaxel and oxaliplatin. Compare reference group with comparison group on operation after chemotherapy, postoperative complications and postoperative pathological conditions. Compare TP1 group with TP2 group on effectiveness and side effects of chemotherapy; Operation after chemotherapy, postoperative complications and postoperative pathological conditions. ResultsThe age distribution, pathologic type and histological grading of lesions of patients in reference group and comparison group have no statistical difference, P>0.05. Total chemotherapy efficiency(CR+PR) of 82 patients in comparison group is 96.3%; Chemotherapy efficiency(CR+PR) of 41 patients in TP1 group is 97.6% and what of 41 patients in TP2 group is 95.2%, the chemotherapy efficiency between TP1 and TP2 has no statistical difference, P>0.05. Among 82 patients in comparison group, 78 patients have squamous cell carcinoma and 4 patients have adenocarcinoma, total chemotherapy efficiency of squamous cell carcinoma is 97%, and what of adenocarcinoma is 75%; For different pathological types, the chemotherapy efficiency difference has statistical significance, P<0.05. After 2 courses' chemotherapy, among 82 patients, 71 patients have characterizations of side effects of chemotherapy, mainly manifest gastrointestinal side effects and hematologic toxic side effects, and the toxic and side effects are minor; Hematological toxicity of TP1 and TP2 groups: leukopenia and neutropenia, there is statistical significance between the two groups, P<0.05; In terms of hemoglobin decrease, there is no statistical significance between the two groups, P>0.05. In terms of traditional radical surgery, the operating time and number of lymph nodes removed between reference group and comparison group have no statistical significance, P>0.05; However, intraoperative blood loss has statistical significance, P<0.05. In this study, 36 patients have postoperative complications, among them, 13 patients in reference group have postoperative complications(37.1%) and 23 patients in NACT neoadjuvant chemotherapy group have postoperative complications(28.1%), the postoperative complications of two groups have no significant difference, P>0.05; Compare TP1 and TP2, there is no significant statistical difference on infection and postoperative thrombosis, etc, P>0.05; There is statistical difference on lymphocyst and complications of urinary retention, P<0.05. There is no statistical difference on vaginal margin between comparison group and reference group, between TP1 and TP2, P>0.05; The difference on lymph node metastasis and vascular invasion positive rate has statistical difference, P<0.05. ConclusionClinically, it is feasible to apply neoadjuvant chemotherapy of combination between paclitaxel liposome and oxaliplatin, between docetaxel and oxaliplatin, and the effect is significant; In addition, in the subsequent implementation of traditional radical surgery treatment, the quality is high, blood loss is less and postoperative complications are fewer, it is worthy of clinical recommendation application. The overall efficiency of medication regimen and chemotherapy of combination between paclitaxel liposome and oxaliplatin, between docetaxel and oxaliplatin is close, however, compared with chemotherapy program of combination between docetaxel and oxaliplatin, after chemotherapy of combination between paclitaxel liposome and oxaliplatin, the side effects are low and maintain a short time; The operation is better; The probability of postoperative lymph node and complications of urinary retention is lower, the pathological response of vaginal margin, lymph node metastasis and vascular invasion positive rate, etc, is weaker.