PVB方案与放射治疗同步进行治疗Ⅱ,Ⅲ期子宫颈癌的疗效观察

Observation of the Effect of PVB Scheme Chemotherapy Concurrent with Radiotherapy in Patients of Stage Ⅱ,Ⅲ Cervical Cancer

目的探讨PVB方案配合放疗治疗Ⅱ,Ⅲ期子宫颈癌患者的临床疗效.方法 106例Ⅱ,Ⅲ期子宫颈癌患者,随机分为同步组及对照组各53例.两组在行同样放疗的基础上同步组同时给予PVB方案(DDP 50mg/m2,d1,长春新碱(VCR) 1mg,d1,BLM 20mg/m2,d1～8)化疗2～4周期.两组放射治疗均用6MV-X线全盆对穿两大野照射,DT 24～28Gy后改为盆腔四野照射并加铱-192后装治疗.结果两组近期有效率平均为100%,差异无显著性.Ⅱ期5年生存率同步组为81.8%,对照组为78.1%,两组差异无显著性(P>0.05).Ⅲ期5年生存率同步组为80%,对照组为52.4%,两组差异有显著性(P<0.05).毒性反应同步组高于对照组,经积极处理均能耐受.结论Ⅱ,Ⅲ期宫颈癌放疗同时配合PVB方案化疗可提高局部控制率和生存率.

Objective To study the effect of PVB scheme chemotherapy concurrent with radiotherapy in patients of stage Ⅱ,Ⅲ cervical cancer. Methods One hundred and six patients of stage Ⅱ,Ⅲ cervical cancer were randomly divided into concurrent group and control group, each group contains 53 cases. The patients in the concurrent group were treated with PVB scheme chemotherapy for 2-4 cycles. All patients were received whole pelvis four areas radiotherapy plus Ir-192 brachytherapy, after whole pelvis two areas radiotherapy at the dose of DT24-28Gy by 6MV x-rays.Results The early efficient rate in both groups is 100%, there is no significant difference between them （P〉0.05）, 5-year survival rate of stage Ⅱ in the concurrent group and control group were 81.8% and 78.1%, there is no significant difference too （P〉0.05）. 5-year survival rate of stage Ⅲ stage in concurrent group（80%） is much higher than control group （52.4%）,（P〈0.05）. although the toxic effects of the concurrent group is higher than control group, it is tolerable after actively therapy. Conclusion Local control and survival rate of radiotherapy concurrent with PVB scheme chemotherapy in patients of stage Ⅱ,Ⅲ cervical cancer is higher than the rate of radiotherapy alone.