63例子宫内膜癌术后联合放射治疗的疗效观察

Effect observation of 63 patients with endometrial carcinoma treated with operation combined radiotherapy

目的观察分析子宫内膜癌手术后辅助放疗的疗效及并发症。方法回顾分析63例子宫内膜癌患者,术后均采用直线加速器盆腔野体外照射,46～50Gy/23f～25f。分析患者年龄、手术病理分期、肌层浸润、病理类型、淋巴结转移等因素与3年生存率的关系,并分析患者急性反应和晚期并发症。结果所有患者中Ⅰ期34例,Ⅱ期12例,Ⅲ期10例,Ⅳ期7例。组织病理学类型:内膜样腺癌57例,腺鳞癌2例,浆液性乳头状腺癌1例,乳头状腺癌2例,管状腺癌1例。全组患者3年总生存率为87.3%。手术病理分期、肌层浸润、淋巴结转移与术后生存率显著相关(P<0.05)。59例(93.7%)出现早期急性放射反应,8例(12.7%)出现晚期并发症。结论对于具有高危因素的子宫内膜癌患者,应根据具体情况制定合理准确的术后放疗方案,最大程度地提高疗效的同时保护正常组织免受不必要的受损,降低并发症,提高肿瘤治疗的增益比。

Objective To observe and analyze the efficacy and complications of operation combined radiotherapy in treatment of endometrial carcinoma. Methods Sixty-three cases of endometrial cancer patients were retrospectively an- alyzed, they were taken pelvic portal vitro in exposure of the linear accelerator with 46-50 Gy/23f-25f. The relation- ship of three-year survival rate and some factors such as age, intraoperative judgments, myometrial invasion, pathologi- cal type, lympho node metastasis and other factors were analyzed. The acute response and late complications were ana- lyzed also. Results In ali patients, 34 cases were in stage Ⅰ , 12 cases were in stage Ⅱ, 10 cases were in stage Ⅲ, 7 cases were in stage IV. The histopathological types were： endometrioid adenocarcinoma in 57 cases, adenosquamous carcinoma in 2 cases, papillary serous adenocarcinoma in 1 case, papillary adenocarcinoma in 2 cases, tubular adeno- carcinoma in 1 case： The overall three-year survival rate of all the patients was 87.3%. Intraoperative judgments, my- ometrial invasion and lympho node metastasis were significantly correlated with postoperative survival rate （P 〈 0.05）. Early acute radiation reactions occurred in 59 cases （93.7%）, late complications occurred in 8 cases （12.7%）. Conclu- sion In accordance with specific conditions, endometrial carcinoma patients with high risk factors should be given a reasonable and accurate postoperative radiotherapy regimen, in order to improve efficacy furthest and protect normal tissue, reduce the complications and improve the gain ratio in tumor therapy.