| Objective: To investigate the clinical efficacy of neoadjuvant chemotherapy in patients with locally advanced cervical cancer to guide the treatment of patients in this region.Methods: This article retrospectively analyzed the results of the pathological diagnosis of cervical cancer in the Department of Obstetrics and Gynecology of the First Hospital of Lanzhou University from January 2013 to December 2017.Gynecologic examination and imaging studies supported 240 patients with stage IB2 and IIA2 clinical stages.Neoadjuvant chemotherapy was divided into observation group and control group.The observation group was neoadjuvant chemotherapy+surgical treatment.Two cycles of intravenous chemotherapy(paclitaxel/docetaxel and cisplatin)were given.After the end of chemotherapy,the efficacy was evaluated and laparotomy was performed.Extensive hysterectomy,the control group performed open laparoscopic/abdominal laparoscopic hysterectomy,and compared the same influencing factors and the same influencing factors between the observation group and the control group.,Urinary catheter removal time,anal exhaust time difference,and two groups of lymphatic vessel invasion,lymph node positive,parametrial infiltration and tumor markers and other indicators,at the same time the subjects were followed up by telephone to analyze the characteristics of recurrent cases.Results: Among the 240 patients included in the study,the age range was 24-75 years and the average age was 47.83±9.34.The 40-50-year-old had the most,accounting for 47.9% of the total number of cases.Among them,highly educated,there were only 35(14.58%)of them(Secondary school and above),the majority(87.90%)of BMI were 18.5-27.9,157(65.40%)of clinical stage IB2,and 83(35.60%)of stage IIA2.There were 228(95%)squamous cell carcinomas,12(5%)non-squamous cell carcinomas,197(82.10%)moderately differentiated,and43(17.90%)well differentiated and poorly differentiated.Among the observational group,97(78.20%)were differentiated,118(95%)were squamous cell carcinomas,and 80(64.50%)were IB2 stage patients.After neoadjuvant chemotherapy,the positive rate of different observations in the group,differentiation and clinical There was no significant difference in staging efficiency of chemotherapy(P>0.05),but in the comparison of pathological types,the chemotherapy efficiency of squamous cell carcinoma was significantly higher than that of non-squamous cell carcinomagroup(P<0.05).The positive rates of CA125 and SCC-Ag in the two groups were compared.After treatment,the observational group was significantly lower than before treatment(P<0.05).In the observation group,the efficacy of tumor treatment was analyzed.Two cases(1.60%)were completely relieved and 85 cases were partially relieved.(68.60%),the effective rate is 70.20%.There were no significant differences in endoscopic hemorrhage,intraoperative blood loss,postoperative hospital stay,number of lymph nodes detected,and ventilation time(P>0.05),but catheter removal was performed after neoadjuvant chemotherapy in the laparoscopic group.The time was significantly shorter than that of the direct surgery group(P<0.05).The same influencing factors were different under the different surgical methods,except for postoperative complications.Compared with other observational indexes,the laparoscopic group was significantly superior to the open group(P<0.05).Laparoscopic group There were 4 cases of extensive uterectomy with autonomic nerves reserved and 2 cases of double J tube implantation before surgery.The incidence of postoperative complications was similar between the two groups(P>0.05).There was no statistical significance,but laparoscopic group In 9 cases of complications,fever was found in6 cases and bladder leakage in 2 cases.In the open group,11 cases had poor knife healing and 4fever.Compared with postoperative pathological examination,the positive rate of the observational group in the parametrial invasion,vasculature metastasis,lymph node positive and muscle infiltration depth was lower than the control group(P<0.05),the difference was statistically significant.During the 5-year telephone follow-up,a total of 233 people were followed up.The average follow-up time was 22.64±14.08 months in the observational group and24.66±13.53 months in the control group.The average recurrence time in the two groups was14.00±2.45 months and 10.50±2.80 months,respectively.The recurrence rates were 10.20% and19.10%,respectively,and the observation period in the tumor-free survival group was longer than that in the control group(P<0.05).The difference was statistically significant.In both groups,there were 2 patients died and there was no significant difference in survival rate within 5 years(P>0.05).Conclusions: Neoadjuvant chemotherapy can significantly reduce tumor volume,effectively reduce the positive rate of SCC-Ag,CA125,lymph node positive,vasculature metastasis,parametrial infiltration rate,and significantly prolong the disease-free urvival period,but no significant effect on long-term survival rate influences. |
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