中晚期宫颈癌同期放化疗联合辅助化疗的近期疗效分析

Analysis on the short - term effect of concurrent radiochemotherapy plus adjuvant chemotherapy in advanced cervical cancer

目的观察宫颈鳞癌患者同期放化疗联合辅助化疗疗效。方法156例Ⅱa-Ⅲb期患者随机分为同期放化疗（实验组）和单纯放疗（对照组）。B点46Gy-50Gy／23f-25f，A点40Gy-48Gy／10f—12f。同期化疗采用DDP40mg/m^2d1，3，5，每周重复。辅助化疗采用TP方案。结果实验组与对照组近期有效率分别为88．61％和75．33％，实验组较对照组有效率显著提高（P〈0．05）。实验组1年和3年总生存率、无转移生存率和局控率较对照组有显著差异（P〈0．05）。所有患者经治疗后生活质量均有明显改善。实验组纳差、腹泻和血液毒性为该治疗模式的限制性毒性（P〈0．05）。结论同期放化疗联合辅助化疗可以提高中晚期宫颈癌患者近期的生活质量．限制性毒性经处理可以耐受。

Objective To observe the effect of concurrent chemoradiotherapy plus adjuvant chemothera py in patients with advanced cervical squamous cell carcinoma. Method 156 cases with stage Ⅱ a - Ⅲ b cervical squamous cell carcinoma were randomly divided into both the concurrent chemoradiotherapy group（ experimental group） and radiotherapy group（ control group）. Radiotherapy was administered by intracavity and external beam radiation therapy,dose of point A were given for 40 Gy -48 Gy/10 f - 12 f and dose of point B for 46 Gy - 50 Gy/23 f- 25 f. In the same time ,experimental group was treated bv DDP 40 mg/d 1,3,5 intravenous drip,repeated every week. Tenth day after radiation therapy, adjuvant chemotherapy using TP program was given three times,21 days intervally. Results The short - term efficiency for the experimental group and the control group was 88.61% and 75.33% respectively （P 〈 0.05 ）. In one year to three year after treatment, the overall survival rate（OS） and distance metastasis free survival rate （DMF） and local recurrence free （LRF） for the experimental group were different significantly （P 〈 0.05 ）than the control group. Quality of life of were significantly improved after treatment. Lack of appetite,diarrhea and blood toxicity of the treatment modalities were observed as limiting toxicity（P 〈 0. 05）. Conclusion Concurrent chemoradiotherapy plus adjuvant chemotherapy for advanced cervical cancer patients can improve short - term and quality of life,the limiting toxicity can be tolerated.