Efficacy Competition Of Neoadjuvant Chemotherapy And Directly With Surgery On Cervical Cancer In Stage ?B-?B

Objective:This study aimed to compare efficacy of neoadjuvant chemotherapy(NACT)and directly with surgery(DS)on cervical cancer in stage ?B-?B.This study also compared two neoadjuvant chemotherapy methods,Intravenous chemotherapy(INCT)and Arterial interventional chemotherapy(TACE),wish to find an ideal treatment,provided a reference for clinical treatment on cervical cancer in stage ?B-?B.Methods:A retrospective study was carried of 322 cervical cancer patients who were confirm by cervical biopsy pathology and in stage ?B-?B from Jan 2010 to Dec 2014 in several first class hospital of Chongqing city.Patients were allocated to three groups in consideration of different treatment,105 patients for Directly with Surgery group,111 patients for Arterial interventional chemotherapy group,and 106 patients for Intravenous chemotherapy group.In other words,there were 217 patients for NACT group.Patients in NACT group were given 1 or 2 course of neoadjuvant chemotherapy prior to hysterectomy pelvic lymphadenectomy surgery.Patients in DS group were given hysterectomy pelvic lymphadenectomy surgery only.Results:Both middle-risk and high-risk factors in DS group were definitely higher in NACT group(95.24% and 62.86% VS56.22% and 32.26%,P<0.01).In NACT group,both middle-risk and high-risk factors in TACE group were definitely higher in INCT group(95.24% and62.86% VS 56.22% and 32.26%,P<0.05).Both adverse pathologic factors and volume of blood loss in NACT group were less than in DS group,but without statistical meaning(P>0.05).The effective rate of NACT group was significantly higher than DS group(68.66% VS 51.43%,P<0.01),and TACE group was significantly higher than INCT group(72.97% VS 64.15%,P<0.01).3-year disease free rates of DS group was 85.71%(15 out of 105 patients died),93.09%(15 out of 217 patients died)for NACT group(P<0.05).3-year disease free rates of TACE group was 94.60%(6 out of 111 patients died),and 89.62%(9 out of 106 patients died)for INCT group,without statistical meaning(P>0.05).Both parametrial involvement(P<0.05)and lymphatic metastasis(P<0.01)of NACT group were significantly lower than DS group.Both parametrial involvement and lymphatic metastasis of TACE group were significantly lower than INCT group(P<0.01).Mean tumor diameter in TACE group was 2.079 ± 0.623 cm,2.569 ± 0.766 cm for INCT group.Compared to?A and ?B patients,?B patients show better effect,with significantly different to ?B patients(P<0.05).Squamous carcinoma patients had significantly higher efficiency rate(P<0.05),with significantly higher efficiency rate in keratinize type(P<0.05).Both of them were significantly shorter than they were prior to treatment(P<0.05).TACE group was significantly shorter than INCT group(P<0.05).None of clinical stage,pathological grade or pathological type showed significantly influence to effective rate(P>0.05),except tumor diameter prior to treatment(P<0.01).Conclusion : NACT treatment based on DDP showed a better efficiency rate and 3-year disease free rate,and a lower pathologic factor,parametrial involvement and lymphatic metastasis than DS.TACE treatment showed a better efficiency rate,and a lower pathologic factor,parametrial involvement and lymphatic metastasis than INCT,but not 3-year disease free rate.Tumor diameter,clinical stage and pathological grade significantly influenced efficiency rate.