同步放化疗治疗中晚期宫颈癌366例临床分析

Concurrent chemotherapy plus radiotherapy for advanced cervical cancer

目的:评价同步放化疗治疗中晚期子宫颈癌的作用。方法:选择2000年10月～2003年5月我科收住的子宫颈鳞癌患者366例,随机分为2组:单纯放疗组188例,采用体外照射加腔内治疗,体外全盆外照DT 30 Gy, 四野外照DT 25 Gy,腔内治疗A点剂量DT 70 Gy以上,7～8周完成。同步放化疗组178例,放疗开始给予全身静脉化疗,化疗方案为DDP+VCR+BLM,化疗3周期,每28天重复治疗。结果:同步放化疗组与单纯放疗组有效率分别为87．08％、55．32％,2组近期疗效差异有统计学意义(P<0．05)。同步放化疗组与单纯放疗组的2年生存率分别为为70．6％、56．7％,差异有统计学意义(P<0．05)。同步放化疗组骨髓抑制及消化道反应发生率均高于单纯放疗组(P均<0．05)。及时对症治疗后,患者均可耐受治疗。远期直肠膀胱并发症并未增加。结论:同步放化疗治疗中晚期子宫颈癌可提高近期疗效及2年生存率。以铂类为基础的化疗疗效肯定,患者能耐受,与化疗联合应用安全、合理。

Objective： To assess the effect of concurrent chemotherapy plus radiotherapy for treatment advanced cervical cancer. Methods： Three hundred and sixty-six patients with advanced cervical cancer were randomized into two groups：Radiotherapy alone group （188 patients） received whole pelvic field plus four field radiotherapy combined with intracavitary irradiation for 70 Gy at point A and 55Gy at point B. Concurrent radiotherapy plus chemotherapy, one cycle per 4 weeks,total 3 cycles. Results： In the group of radiotherapy alone, the response rate was 55.32% and the 2-year survival rate was 56.7%. In the group of concurrent radiotherapy plus chemotherapy, the response rate was 87. 08% and the 2-year survival rate was 70. 6%. There were significant differences in two groups （P〈0.05）. More serious toxicity was found in the group of concurrent radiotherapy plus chemotherapy, but it was tolerable. Conclusions： Concurrent chemoradiotherapy for advanced cervical cancer can significantly improve the 2-year survival rate and it was better-tolerated in toxicity.