同步放化疗治疗中晚期宫颈癌的临床疗效观察

Effects of Synchronous Chemoradiotherapy on Patients with Uterine Cervix Cancer of Middle and Advanced Stage

目的：探讨同步放化疗治疗中晚期宫颈癌的疗效及毒副作用。方法：将病理确诊为Ⅱb-Ⅲb期宫颈癌176例患者,随机分为同步组及对照组各88例。两组放疗均用6 mv-x线全盆对穿大野照射,DT 20-24 Gy后改为盆腔四野照射并加铱192后装治疗。同步组同时给予化疗顺氯氨铂40 mg,博来酶素15 mg,5-FU 1.0 g,d1-3,2-3周期,对照组行单纯放疗。结果：两组近期有效率平均为100%,差异无统计学意义（P〉0.05）。Ⅱ期5年生存率,同步组为82.0%,对照组78.0%,两组差异无统计学意义（P〉0.05）。Ⅲ期5年生存率同步组为78.9%,对照组为50.0%,两组差异有统计学意义（P〈0.05）;同步组毒性反应高于对照组,经积极处理均能耐受。结论：同步放化疗能提高肿瘤局部控制率,降低复发率,减少局部淋巴结和远处转移率,有效提高长期生存率,且并发症的发生率较低,是一种简单、安全、较理想的中晚期宫颈癌的治疗方案。

Objective:To investigate the effects and the side effects of synchronous chemoradiotherapy in patients with uterine cervix cancer of middle and advanced stage.Metholds:176 patients with uterine cervix cancer in stage IIb-IIIb were divided into synchronous chemoradiotherapy group(88 cases) and control group(88 cases).After radiotherapy,the patients in synchronous chemoradiotherapy group were given chemotherapy(DDP40mg d1~3,BLM15mg d1~3,5-FU1.0g d1~3) for or 3 weeks,while the patients in control group were given radiotherapy alone.Results:The short-time effective rate are the same in two groups.The five year survive rate of patients with uterine cervix cancer in stage II in synchronous chemoradiotherapy group has no difference with control group(82.0% versus 78.0%,P>0.05).However,The five year survival rate of patients with uterine cervix cancer of stage III in synchronous chemoradiotherapy group is higher than that of control group(78.9% versus 50.0%,P<0.05).The side effects are seen to be more common in chemoradiotherapy group than those in control group.Conclusion:Synchronous chemoradiotherapy benefits the tumor size control,minimizes the recurrence and the regional nodes and distant metastasis and improves the long term survival.Besides,its side-effects could be tolerated completely.Therefore,synchronous chemoradiotherapy is a simple and safe therapeutic regimen.