早期高危宫颈癌术后同步放化疗的临床研究(1)
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【摘要】 目的 研究早期高危宫颈癌术后不同辅助治疗的疗效和毒副反应。方法 78例早期高危宫颈癌术后高危患者分为同步放化组(放化组)40例及单纯放疗组(单放组)38例,两组均于术后2～3周开始放疗,放疗方法相同,均采用6MV-X线四野盒式照射,常规剂量分割,盆腔中心总剂量为DT45～50Gy。同步化放组在放疗的同时予DDP化疗。结果 放化组与单放组3年内盆腔内复发率无显著性差异,盆腔外复发率放化组低于单放组,差异有显著性意义;3年生存率分别为92.5%和76.3%,差异有显著性(P<0.05)。毒副反应中只有胃肠道反应放化组发生率高,骨髓抑制、膀胱炎和直肠炎等毒副反应与单放组比较差异无统计学意义(P>0.05),经对症处理均能耐受。结论 早期高危宫颈癌术后同步放化疗治疗可提高3年生存率,且降低盆腔外的复发率,毒副反应能耐受,值得临床使用。
【关键词】
宫颈癌;辅助治疗;同步放化疗
Clinical Reseach Of Concurrent Chemoradiotherapy For The Early Stage Postoperative Cervical Cancer With High-risk Factors
QI Shi-fang, LIU Hua,TIAN Xiao-yu.Department of Obstetrics and Gynecology, The first Affiliated Hospital of Henan University of science and technology， luoyang 471003，China
【Abstract】 Objective To investigate the effect and adverse reaction of concurrent chemoradiotherapy and radiotherapy on early stage postoperative cervical carcinoma with high-risk factors. Methods Seventy eight patients of early stage post operative cervical carcinoma with high-risk factors were randomly divided into two groups， 40 cases received concurrent chemoradiotherapy and 38 cases received radiotherapy. Two groups received the same radiotherapy. The concurrent chemoradiotherapy group were given cisplatin when irradiated. Results The intrapelvic recurrence rate of two groups were no significant difference. The extrapelvic recurrence rate of the concurrent chemoradiotherapy group was significant lower than the radiotherapy group.The 3-year survival rates of radiotherapy group and concurrent chemoradiotherapy group were 92.5% and 76.3% respectively.There were significant difference between them. Only the gastrointestinal tract reaction among the complication and adverse reaction in chemoradiotherapy group were significant heavier than in radiotherapy group. Conclusion The effect of concurrent chemoradiotherapy on early stage postoperative cervical carcinoma with high-risk factors could increase the survival rate of the patients. The adverse reaction of two groups was no significant difference but gastrointestinal tract reaction. The patients could tolerate. It is reasonable and effective therapy.
【Key words】 Cervical carcinomas；Adjunctive therapy；Concurrent chemoradiotherapy
宫颈癌是最常见的妇女生殖器恶性肿瘤,严重威胁妇女的身体健康,宫颈癌的根治性手术是早期宫颈癌的根治性治疗方法,其疗效已得到肯定,然而当术后发现存在高危因素宫颈癌患者(盆腔淋巴结阳性、局部肿瘤大于4cm或侵犯子宫颈深肌层、病理分化程度差、宫旁切缘阳性)需配合术后辅助治疗,术后辅助治疗能有效的降低复发率,对于早期高危宫颈癌患者根治术后加用何种辅助治疗更为有意义?对于远处转移和长期生存率有无明显改善?本文对2003年5月到2007年5月在我院治疗的78例早期高危宫颈癌患者进行回顾性分析,现总结如下 ......
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