顺铂加一体化后装腔内放疗在早期巨块型宫颈癌治疗中的临床研究

Integrated brachytherapy with chemotherapy of cisplatin for early-staged bulky cervical cancer

目的:探讨顺铂加一体化后装腔内放疗在早期巨块型宫颈癌治疗中的临床应用价值。方法:将我院2003年8月至2006年12月收治的且具备手术条件的82例Ⅰb、Ⅱa期巨块型宫颈癌患者随机分为两组,即研究组(A组,42例)和对照组(B组,40例),两组手术前均给予一体化后装治疗,A组于后装治疗的前4～6h给予顺铂30mg/m2,静脉滴注,观察两组患者的近期治疗效果及不良反应。结果:两组患者后装治疗前后局部病灶变化明显,差异均具显著性(P<0.05);两组术前比较局部病灶变化差异亦有显著性(P<0.05);对两组患者的毒副反应进行比较,无统计学意义(P>0.05);术中、术后高危病理因素A组低于B组,但差异均无显著性(P>0.05);1、2、3年生存率无显著性差异(P>0.05)。结论:顺铂加一体化后装腔内放疗治疗早期巨块型宫颈癌临床疗效显著,能降低术中、术后高危病理因素,毒副反应无增加,值得临床推广应用。

Objective：To explore the clinical value of integrated brachytherapy with chemotherapy of cisplatin for the treatment of early-staged bulky cervical Cancer. Methods：Between Aug, 2003 to Dec, 2008,82 previously untreated patients with FIGO stage ⅠB-Ⅱ A bulky cervical cancer admitted to the operating room for radical hysterectomy were randomly divided into two groups, the observation group （Group A, including 42 patients who received integrated brachytherapy with chemotherapy of cisplatin, 30 mg/m^2 iv within 4-6 hours before integrated brachytherapy）, and the control group （Group B,including 40 patients who received integrated brachytherapy alone）. The irradiation dose of reference point in the two groups was the same, The short-term therapeutic efficacy and side effects were compared between the two groups. Results： Great changes of local tumour volume took place in Group A after integrated brachytherapy,in addition,there was a significant diference in changes of local tumour volume before the operation between the two groups（P〈0. 05）. There was no significant diference in the side effects or in the 1,2,3-year survival rate between the two groups（P〈0.05） ,there were less postoperational high risk pathology factors in GroupA than those in GroupB,but without significant diference（P〉0. 05）. Conclusious：Integrated brachytherapy with chmotherapy of eisplatin is an effective way for the treatment of early- staged bulky cervical cancer, can cut down postoperational high risk pathology factors and is promissing in clinical practice, with few side effects.