中晚期宫颈鳞癌放化疗后复发未控相关因素分析

Analysis of Clinical and Pathological Factors of Persistent or Recurrent Medium-term and Advanced Cervical Squamous Carcinoma

目的:探讨中晚期宫颈鳞癌放化疗后复发未控的相关因素,以提高宫颈鳞癌放化疗的疗效。方法:对我院2007年1月至2009年12月收治的166例中晚期宫颈鳞癌进行回顾性分析,其中复发未控38例(复发未控组),无复发未控128例(无复发未控组),比较两组的临床分期、组织学分级、肿瘤大小、淋巴结转移、治疗前Hb水平、放疗剂量、化疗疗程及放疗时间,分析其与复发未控的关系。结果:复发未控组组织学分级低分化、宫颈局部癌组织≥4cm、有淋巴结转移、治疗前Hb水平低所占比例与无复发未控组比较,差异均有统计学意义(P<0.05)。复发未控组化疗疗程>3、放疗时间超过8周所占比例与无复发未控组比较,差异均有统计学意义(P<0.05);而放疗剂量与复发未控无明显的相关性。结论:肿瘤分化程度低、宫颈局部癌组织大、有淋巴结转移、治疗前Hb水平低的宫颈鳞癌患者放化疗后易发生复发未控,而化疗疗程及放疗时间也是影响中晚期宫颈鳞癌放化疗后复发未控的因素。

Objective： To explore the relevant factors of persistent or recurrent medium-term and advanced cervical squamous carcinoma for improving the therapeutic efficacy of radiation and chemotherapy. Methods ：The clinical data of 166 cases of persistent or recurrent medium-term and advanced cervical squamous carcinoma were retrospectively studied in Changzhou Tumor hospital between January,2007 and December,2009. The 166 patients were divided into two groups ：38 cases were in persistent or recurrent group, 128 cases were no persistent or recurrent group, the clinical stage, tumor differenitiation, tumor size, lymph node metastasis,the hemoglobin level before treatment, radiotherapy dose,cycles of chemotherapy and ra- diotherapy treatment between the two groups were compared. And the relationship between these factors and persistence or recurrence of cervical squamous carcinoma were also analyzed. Results：There were significant differences in tumor differentiation, tumor size, lymph node metastasis, the hemoglobin level before treatment between the two groups （ P 〈 0.05）. Patients with chemotherapy less than three cycle, radiotherapy treatment time beyond eight weeks were related to persistence or recurrence of cervical squamous carcinoma （P 〈0.05） ,and radiotherapy dose had no relationship with persistence or recurrence of cervical squamous carcinoma. Conclusions： Low tumor differentiation,tumor size more than 4 cm, lymph node metastasis and low level hemoglobin before treatment are the relevant factors of persistent or recurrent mediumterm and advanced cervical squamous carcinoma,cycles of chemotherapy and radiotherapy treatment time can also influent the persistent or recurrent mediumterm and advanced cervical carcinoma greatly.