中晚期宫颈癌同步放化疗的临床研究

Curative effect of synchronous radio-chemotherapy in medium-term and advanced cervical carcinoma

目的:分析同步放化疗对于中晚期宫颈癌患者的临床治疗效果及不良反应。方法:选取33例我科治疗的中晚期宫颈癌患者,随机分为观察组16例和对照组17例,观察组采取同步放化疗,对照组仅使用根治性放疗,比较两组患者的近期疗效、3年生存率及不良反应等。结果:(1)观察组患者中CR 13例,PR 2例,SD 1例;对照组中CR 11例,PR2例,SD 3例,还有1例患者为PD,经比较发现观察组疗效明显优于对照组(P<0.05)。(2)经比较发现,观察组IIb期和III期患者3年生存率高于对照组(P<0.05),而两组IV期均无3年生存病例(P>0.05);观察组复发和远处转移均明显低于对照组(P<0.05)。(3)对照组骨髓抑制和胃肠道反应明显低于观察组(P<0.05);两组患者发射型直肠炎、尿道炎及膀胱炎差异不明显(P>0.05)。结论:同步放化疗较单纯放疗能提高中晚期宫颈癌3年生存率,并有效降低局部复发率及远处转移率,临床使用安全。

Objectives： To study the curative effect of synchronous radio -chemotherapy in medium -term and advanced cervical carcinoma. Methods： Thirty - three patients with medium - term and advanced cervical carcinoma in our department were randomly divided into two groups, with 16 patients in the observation group and 17 patients in the control group. The obser- vation group were treated with synchronous radio- chemotherapy, and the control group received radiotherapy only. Short -term effect, 3 - year survival rate and complications of the two groups were compared. Results： （!） In the observation group, patients of complete remission （CR）, partial remission （PR） and stabilization （SD） are 13, 2 and 1 respectively. In the control group, patients of complete remission （CR）, partial remission （PR）, stabilization （SD） and progression of disease （PD） are 11,2, 3 and 1. By comparison, the observation group has better clinical effect than the control group（ P 〈0.05 ）. ~）the patients of stage IIb and m in the observation group have significantly better 3 - year survival rate than the control group（P 〈0.05）. No patients of stage IV in both groups survived for three years. The observation group has significantly lower local recurrent and distant matas- tasis than the control group（ P 〈 0.05 ）. （~）Myelosuppressian and gastrointestinal reactions of the observation group are lighter than those of the control group（P 〈 0.05 ）. There was no significant difference between the two groups in terms of radiation proctitis, urethritis and cystitis. Conclusions： Synchronous radio - chemotherapy in medium - term and advanced cervical carcinoma can effectively improve 3 - year survival rate and decrease local recurrent and distant matastasis rate.