晚期子宫颈癌同时放化疗的临床观察

Clinical study on concurrent radiotherapy and chemotherapy in advanced cervical cancer

目的：探讨晚期子宫颈癌同时放化疗的临床疗效及其副反应。方法：８４例晚期子宫颈癌患者随机分为同时放化疗组和单纯放疗组。两组均给全盆外照２５Ｇｙ，盆腔四野照射２５～３０Ｇｙ，腔内Ａ点量３５～４０Ｇｙ。同时放化疗组于放射治疗的同时给予ＤＤＰ５０ｍｇ／ｍ２静脉滴注，每３周１次，共４次，观察近期疗效及毒副反应，并长期随访。结果：同时放化疗组的总有效率为８５．７％，单纯放疗组的总有效率为６５．９％（Ｐ＜０．０５）；同时放化疗组的５年生存率为５１．４３％，单纯放疗组为４５．４５％（Ｐ＞０．０５）。同时放化疗组的白细胞下降率和恶心呕吐的发生率均高于单纯放疗组（Ｐ＜０．０５和Ｐ＜０．０１），腹泻、血便和血尿发生率两组差异均无显著性（Ｐ＞０．０５）。结论：同时放化疗是治疗晚期子宫颈癌的一种安全而有效的方法。

Objective:To investigate the therapeutic effect and side effect of concurrent radiotherapy and chemotherapy in patients with advanced cervical cancer.Methods:Eight four cases with advanced carcinoma of cervix were divided into two groups:group 1 was treated concurrently with radiotherapy and chemotherapy(35 cases) and group 2 with radiotherapy only(44 cases).Both two groups were given the same external irradiation and intracavity irradiation;the external irradiation was given in dose of 50～60 Gy on the plan of pelvis,the intracavity irradiation at point A in dose 35～40 Gy.In concurrent radiotherapy and chemotherapy group DDP 50 mg/m 2 was given once every 3 weeks for 4 times at the same time with the radiotherapy.Results:The overall effective rates were 85.7% and 65.9% nespectivety( P <0.05) and the 5 year survival rates were 51.43% and 45.45%( P >0.05) respectively for group 1 and 2. The side effect of the concurrent radiotherapy and chemotherapy were leukopenia and gastrointestinal disturbances.Conclusions:The concurrent use of radiotherapy and chemotherapy is a safety and effective method for treatment of advanced cervical cancer.