Thermo-coagulation versus cryotherapy for treatment of cervical precancers: A prospective analytical study in a low-resource African setting
Thermo-coagulation versus cryotherapy for treatment of cervical precancers: A prospective analytical study in a low-resource African setting
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DOI：
10.1111/jog.14139
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发表时间：
2019-10-08
影响因子：
1.6
通讯作者：
Onyebuchi, Azubuike K.
中科院分区：
文献类型：
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作者：
Chigbu, Chibuike O.;Onwudiwe, Elijah N.;Onyebuchi, Azubuike K.
目的 评估冷冻疗法和热凝疗法治疗宫颈癌前病变的效果。方法 前瞻性分析研究。醋酸目视检查呈阳性并通过瑞典评分阴道镜检查确认的女性被随机分配接受冷冻疗法或热凝疗法。 6个月后，参与者接受了重新评估。结果 共有 11 124 名女性接受了筛查。 1294 例阴道镜确诊阳性病例中，只有 1023 例符合消融治疗条件。 512 名女性接受了冷冻治疗，511 名女性接受了热凝治疗。冷冻疗法与热凝疗法的治愈率相似（85.5% vs 89.2%，P = 0.09）。热凝治疗的患者平均满意度评分高于冷冻治疗（3.9 +/- 1.3 vs 2.8 +/- 1.7；P < 0.0001）。冷冻疗法的每位患者的平均治疗持续时间高于热凝疗法（660.0 +/- 0.0 vs 50.9 +/- 15.3 s，P < 0.0001）。冷冻疗法的每位患者平均治疗费用显着高于热凝疗法（2613.1 +/- 254.9 vs 533.2 +/- 45.2 尼日利亚奈拉，P < 0.0001）。接受热凝治疗的女性中报告没有副作用的比例较高（55.2% vs 12.5%，P < 0.0001）。结论冷冻疗法与热凝疗法治疗宫颈癌前病变的疗效相似。与冷冻疗法相比，热凝疗法成本更低，治疗持续时间更短，副作用更少，患者满意度更高。热凝应该是世界资源匮乏地区推荐的消融治疗方法。
Aims To evaluate the outcomes of cryotherapy and thermo-coagulation in the treatment of cervical precancers. Method Prospective analytical study. Women who screened positive to visual inspection with acetic acid and confirmed by colposcopy using the Swede's score were randomized to receive either cryotherapy or thermo-coagulation. Participants were re-evaluated 6 months later. Results A total of 11 124 women were screened. Only 1023 of the 1294 colposcopically confirmed positive cases were eligible for ablative therapy. Five hundred and twelve women received cryotherapy while 511 women received thermo-coagulation. Cryotherapy had similar cure rate with thermo-coagulation (85.5 vs 89.2%, P = 0.09). The mean patient satisfaction score for thermo-coagulation was higher than that for cryotherapy (3.9 +/- 1.3 vs 2.8 +/- 1.7; P < 0.0001). The mean duration of treatment per patient was higher for cryotherapy than thermo-coagulation (660.0 +/- 0.0 vs 50.9 +/- 15.3 s, P < 0.0001). The mean cost of treatment per patient was significantly higher for cryotherapy than for thermo-coagulation (2613.1 +/- 254.9 vs 533.2 +/- 45.2 Nigerian Naira, P < 0.0001). Higher proportion of women who had thermo-coagulation reported no side effect (55.2 vs 12.5%, P < 0.0001). Conclusion Cryotherapy and thermo-coagulation have similar efficacy in the treatment of cervical precancers. Thermo-coagulation offers lower cost and lower duration of treatment, less side effects and higher patient satisfaction than cryotherapy. Thermo-coagulation should be the recommended ablative treatment method for low-resource settings of the world.