宫颈鳞癌放疗失败的病理临床分析

Clinicopathological Analysis of Radiotherapy Failure in Squamous Carcinoma of Cervix

目的 探讨宫颈鳞癌放射治疗失败的临床病理因素。方法 对1998年1月～2000年1月进行放疗的256例宫颈鳞癌患者进行5年的随访，分析治疗失败与病灶的大小、分化程度和临床分期的关系。结果 256例宫颈癌放疗后5年内失败率为28．51％（71例），其中未控为8．02％（21例）；复发16．58％（39例）。有5．08％（11例）发生远处转移；病灶直径≥4 cm的患者的治疗失败率为37．93％，明显高于病灶直径〈4 cm患者的19．85％，矿检验P〈0．01。Ⅲ期以上组的治疗失败率为39．74%、治疗未控率16．66％分别高于Ⅱh期患者的16．66％和4．49％．P值〈0．01；低分化组的失败率为31．91％，比中分化组（26．62％）、高分化组（27．27％）的失败率稍高，但X^2检验没有显著性差异。结论 肿瘤直径大、临床分期晚是宫颈鳞癌放疗失败的重要因素。

Objective To explore the correlations between the size, clinical staging, pathological type and radiotherapy failure in squamous carcinoma of ccrvix, Methods The 5-year radiotherapy failure rate and the factors the prognosis of 256 cases of cervical carcinoma were analyzed retrospectively.Results The 5-year disease free survival rate of stage Ⅱ b（77.53%） were significantly higher than that of stage Ⅲ-Ⅳ （60.25 %）. P 〈 0.01 ; The 5- year radiotherapy failure rate of masses ≥4cm in diameter （37.93 % ） were significantly higher than that of masses 〈4cm in diameter smaller （19.85 % ） . P 〈0. 01; No correlation was found between the alteration of level of histopathologieal differentiation.Conclusions Tumor size and clinical staging are the influencing factors of radiotherapy failure in advanced squamous carcinoma of cervix.