Retrospective Analysis Of The Effect Of Neoadjuvant Chemotherapy On Local Advanced Cervical Cancer

Objective:To explore the clinical value of neoadjuvant chemotherapy,We retrospectively analyzed the clinical data of patients with locally advanced cervical cancer treated with surgery after neoadjuvant chemotherapy and radical surgery without neoadjuvant chemotherapy pin this study.Methods:We collect the clinical data of the cases diagnosed by locally advanced cervical cancer from December,2012 to June,2017 in Yijishan Hospital.All of them have underwent radical hysterectomy.Through the analysis of data,We found that the patients applying neoadjuvant chemotherapy before surgery were mostly those with cervical cancer(IB2/IIA2)were treated as subjects.According to the exclusion criteria,93 cases were included in the study.They were divided into three groups,group A(intra-arterialchemotherapy group n = 32)? group B(intra-venous chemotherapy,n = 21)and group C(radical surgery without neoadjuvant chemotherapy group,n = 40).The response rate were evaluated in group A/B.Group A and group B was respectively compared with group C by comparing the pathologic results and operationstatus to evaluate the clinical value of neoadjuvant chemotherapy.We analyzed the statistical by the statistical methods like chi-square test,T test and Fisher exact test.Results:RR:The response rate of group A was 65.630%.According to FIGO,the RR of IB2,IIA2 was respectively 66.67%,64.71%.The differences between the groups has no statistical significance.According to the tumor histologic types,the RR of squamous carcinoma Is significantly higher than the non-squamous carcinoma.The response rate of group B was 61.90%.According to FIGO,the RR of IB2,,IIA2 was 50%,64.71%.The differences between the groups has no statistical significance.According to the tumor histologic types,the difference has no statistical significance.Operationstatus : The mean operation time and mean blood loss of group A is slightly greater than group C(P >0.05).The mean operation time and mean blood loss of group B was slightly less than group C(P=0.001/0.076).The difference has statistical significance.Comparison of the pathologic results: The comparation of vascular infiltratio and lympho-vascular space involvement(LVSI)in both groups A and B were higher than group C(P<0.05).The result showed significant differences between them.Complications : The incidence of complications in group A,B,C was28.12%,28.57%,32.50% Respectively.The difference between group AandC has no significans,so was group B and C.Conclusion:(1)To the locally advanced cervical cancer(LACC),neoadjuvant chemotherapy(NACT)is a safe and effective treatment.Two kinds of new adjuvant chemotherapy are both beneficial for radical resection.The recent curative effect is significant and has nothing to do with FIGO clinical stage and degrees of pathologica,but is related to tumor histologic types.(2)Both the intra-arterialchemotherapy and intra-venous chemotherapy before the surgery would not Increase the bleeding and operative time,so was the incidence of surgical complications.(3)Both the intra-arterialchemotherapy and intra-venous chemotherapy can reduce the risk factors such as vascular infiltratio and lympho-vascular space involvement(LVSI).(4)The chemotherapy drugs of the two neoadjuvant chemotherapy were different in YiJiShan Hospital,so we could not compare the datas bteween them directly.It required follow-up prospective study,to know the difference btween them.(5)It still need further explore to study wherther NACT can increase the long-term survival rate of locally advanced cervical cancer.