放疗联合化疗治疗晚期宫颈癌的临床观察

Short-term efficacy of chemotherapy combined with radiotherapy in advanced cervix cancer

目的:观察放化疗同步治疗晚期宫颈癌的近期疗效及急性不良反应。方法:初次治疗的Ⅲb期宫颈癌患者60例,随机分为单放组和放化组各30例。放疗采用加速器体外照射+192Ir腔内后装治疗,体外剂量50Gy/25f/5w(36Gy时中央挡铅),腔内照射A点总剂量42Gy/6f。化疗方案,顺铂20-30mg/m2,静脉滴注,第1-4天,5-FU500mg/m2,d1-5,静脉滴注,共2周期。结果:单放组CR 40.0%,PR 23.3%;放化同步组CR67.7%,PR 23.3%(P<0.05)。两组总有效率单放组63.3%,放化组90.0%(P<0.05)。放化疗期间的不良反应,单放组骨髓抑制和胃肠道反应都较轻,而放化同步组较单放组重。结论:放化疗联合应用能提高晚期宫颈癌局部控制率,同时放化疗的不良反应也有增加,但患者均能耐受。

Objective：To evaluate the short-term efficacy and acute toxicity of chemotherapy combined with radiotherapy in advanced cervix cancer.Methods： Sixty patients with stage Ⅲb cervix cancer were randomized into observation group（chemotherapy plus radiotherapy group） and radiotherapy alone group.Radiotherapy in both groups was administered with one-daily external irradiation doses of 2Gy to pelvis,5d/wk and brachytherapy to deliver a total dose of 42Gy to point A.Chemotherapy： cisplatin 20-30mg/m2,d1-4;5-FU 500mg/m2,d1-5,for two cycles.Results： The total effective rate was higher in observation group than that in the radiotherapy alone group（P0.05）.Acute toxicity reaction in creased in observation group but was tolerable.Conclusion： Chemotherapy combined with radiotherapy may improve the short-term therapeutic efficacy of advanced cervix cancer and the patients can endure the side effects.