热疗、化疗联合放疗治疗宫颈癌的疗效观察

Curative effect observation of thermotherapy,chemotherapy united with radiotherapy on cervical cancer

目的观察腹腔热疗联合静脉化疗、放疗治疗宫颈癌的临床疗效及不良反应。方法将病理检查确诊的Ⅱb～Ⅲb期宫颈癌患者随机分为放化组39例和热放化组42例,放化组给予外照射及腔内照射后,多西他赛75 mg/m2+顺铂70 mg/m2静脉滴注化疗;热放化组:在放疗后1周给予多西他赛75 mg/m2静脉滴注,顺铂70 mg/m2行腹腔化疗,腹腔灌注顺铂后行腹部高频加热1 h,温度为41～45℃。用药期间动态监测生命体征、观察不良反应的发生等,6周期后评价疗效。结果放化组近期有效率为49%,热放化组为83%,2组比较有显著性差异(P<0.05);热放化组完全缓解率为55%,明显高于放化组的28%,2组比较有显著性差异(P<0.05);热放化组的改善率67%高于放化组的改善率38%,2组比较有显著性差异(P<0.05);热放化组治疗过程中的恶心呕吐及骨髓抑制引起的血细胞下降高于放化组,2组比较有显著性差异(P<0.05)。结论热疗、化疗联合放疗治疗宫颈癌可显著提高治疗效果,无严重的并发症,是中晚期宫颈癌治疗中的一种安全有效的方法。

Objective It is to observe the clinical curative effect and untoward reaction of intraperitoneal thermotherapy united with intravenous chemotherapy and radiotherapy on cervical cancer.Methods The pathological examination confirmed on Ⅱb-Ⅲ b cervical caner patients were randomly divided into radiochemotherapy group（39 cases） and heat radiochemotherapy group（42 cases）.The radiochemotherapy group was treated with docetaxel 75 mg/m^2 and cisplatin 70 mg/m^2 intravenous chemotherapy after external beam and intracavitary irradiation.The heat radiochemotherapy group was treated with abdominal high frequency heating with a temperature of 41-45 ℃ for 1 h based on the treatment of the radiochemotherapy group.The vital signs and the incidence of the untoward reaction during the treatment were monitored.The curative effect was evaluated after 6 cycles.Results The recent effective radio of the chemotherapy group was 49% and that of the heat radiochemotherapy group was 83%,the difference was statistically significant（P〈0.05）.The complete remission rate of the heat radiochemotherapy group was 55%,which was obviously higher than that of the chemotherapy group（28%） and the difference was statistically significant（P〈0.05）.The improvement rate of the heat radiochemotherapy group was 67%,which was higher than that of the chemotherapy group（38%） and the difference was statistically significant（P〈0.05）.The nausea and vomiting during the treatment course and blood cells decreased caused by bone marrow suppression in the heat radiochemotherapy group were higher than that of the chemotherapy group and the difference was statistically significant（P〈0.05）.Conclusion The treatment of thermotherapy,chemotherapy united with radiotherapy on cervical cancer can significantly improve the curative effect and no serious complications,which is a safe and effective method in the treatment of cervical cancer in metaphase and advanced stage.