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中国癌症防治杂志

中国癌症防治杂志

• 论文 • 上一篇    下一篇

中晚期宫颈癌同步放化疗疗效分析

董春莉;孔岩;丁岩;崔顺花;   

  1. 吉林省延边肿瘤医院放疗科;
  • 收稿日期:2010-09-25 修回日期:2010-09-25 出版日期:2010-09-25 发布日期:2010-09-25

Effect of concurrent chemoradiotherapy on intermediate and advanced cervical cancer

DONG Chun-li,KONG Yan,DING Yan,et al.   

  1. (Department of Radiotherapy,Yanbian Tumor Hospital,Jilin 133000,China
  • Received:2010-09-25 Revised:2010-09-25 Online:2010-09-25 Published:2010-09-25

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被引次数

33

摘要： 目的探讨单纯放疗和同步放化疗两种治疗方法对局部晚期宫颈癌的临床疗效及不良反应。方法将136例局部晚期宫颈癌随机分为单纯放疗组(单放组)和同步放化疗组(放化组)各68例。放疗:两组患者均采用192Ir高剂量率腔内加体外放疗,盆腔放疗剂量DT36～40Gy后,开始中间挡铅腔内后装治疗4～6次,A点剂量达到DT66～70Gy。以宫颈残留病灶黏膜下1.0～1.5cm为参考点,给宫颈长3cm单管放疗2～3次。化疗:放化组采用顺铂50mg/m2静脉滴注,d1;氟尿嘧啶(5-FU)4000mg持续96h泵入。每4周重复,共用3个周期。结果单放组和放化组均按计划完成治疗,总有效率分别为83.8%和95.6%(χ2=5.096,P=0.024);单放组1、3、5年生存率分别为80.9%、60.3%、50.0%,放化疗组1、3、5年生存率分别为88.2%、75.0%、66.2%。早期放射性直肠反应发生率放化组为17.6%,单放组为13.2%;膀胱反应发生率放化组为7.4%,单放组为4.4%。放化组远处转移率(17.6%)明显低于单放组(38.2%)(P<0.05),放化组的骨髓抑制和消化道反应明显高于单放组,但患者经一般对症处理后均能耐受。结论局部晚期宫颈癌同步放化疗优于单纯放疗,能提高患者生存率,降低远处转移率。

关键词: 宫颈癌, 同步放化疗, 生存率, 转移率, 不良反应

Abstract: Objective To investigate the curative effect and adverse reaction of concurrent chemoradiotherapy (CCRT) on intermediate and advanced cervical cancer.Methods136 patients with intermediate or advanced cervical cancer were randomly divided into CCRT group and radiotherapy group,each group had 68 patients.Radiotherapy for both groups was by using high dosage rate of 192Ir on intracavity and external portion.Chemotherapy for the patients in CCRT group was by using three cycles of Cisplatin plus 5-FU.ResultsTotal effective rates in CCRT group and radiotherapy group were 95.6% and 83.8% respectively (χ2=5.096,P=0.024).The 1-,3-and 5-year survival rates in CCRT group were 88.2%,75.0% and 66.2% respectively,while they were 80.9%,60.3% and 50.0% respectively in radiotherapy group.The incidence rates of early radioactive rectum reaction in CCRT group and radiotherapy group were 17.6% and 13.2% respectively,and the incidence rates of bladder reaction in these two groups were 7.4% and 4.4% respectively.The metastasis rate in CCRT group was much lower than that in radiotherapy group.The bone marrow suppression and gastrointestinal reaction were more serious in CCRT group than those in radiotherapy group,but patients were usually able to tolerate the sickness after symptomatic treatment.ConclusionsThe effect of CCRT on intermediate and advanced cervical cancer is superior to radiotherapy,as it could reduce metastasis rate and enhance survival rate.

Key words: Cervical cancer, Concurrent chemoradiotherapy (CCRT), Survival, Metastasis, Adverse reactions