同步放化疗与放疗对早期子宫颈癌手术患者生存率的影响

Effect of Concurrent Chemoradiotherapy and Radiotherapy on the Survival Rate of Patients with Early Cervical Cancer

目的探讨对于早期宫颈癌患者采用同步放化疗以及单独放疗的治疗方案的临床疗效差异,为早期宫颈癌的治疗提供依据。方法对我院自2004年6月至2008年6月期间收治的86例子宫颈癌患者的临床资料进行总结分析。将其分为两组,对照组34例患者采用单独放射治疗手段,研究组52例患者采用同步放射治疗联合化学治疗方案。制定疗效判定标准,对比两组患者治疗后的临床疗效。并对患者进行为期5年的随访,统计患者在治疗后的5年内生存、复发、肿瘤转移等情况,采用SPSS 17.0对数据进行统计学分析。结果两组患者在治疗后的短期时间内,总有效率均为100%,无显著差异(P>0.05),但缓解率与部分缓解率有显著差异(P<0.01);5年随访期内,对照组患者9例死亡,25例存活,其中无进展生存患者4例,肿瘤向远传转移患者2例,复发患者6例,13例患者生存质量较好;研究组患者4例死亡,48例存活,其中无进展生存患者5例,肿瘤向远传转移患者2例,复发患者5例,36例患者生存质量较好。两组患者5年生存率有显著差异(P<0.01)。结论当患者手术时并未完全清除病灶的情况下,放疗效果无法对患者的5年生存率有较为显著的提高,但同步放化疗可以达到理想的临床治疗效果。具有不良预后的宫颈癌患者在手术后无论接受同步放化疗或单独放射治疗,都具有一定的临床效果,提高其生存概率以及患者的生活质量。肿瘤往远处进行转移是治疗无法达到预期效果的主要原因。

Objective To explore the difference in the clinical effect of concurrent chemoradiotherapy and radiotherapy alone on patients with early cervical cancer, so as to provide a basis for the treatment of early cervical cancer. Methods The clinical data of 86 cervical cancer patients admitted to our hospital from June 2004 to June 2008 were summarized and analyzed. The patients were divided into two groups, 34 patients in the control group received radiotherapy alone and 52 patients in the experimental group received concurrent radiochemotherapy. Effect judgement criteria was formulated to compare the clinical effect of the two groups. A 5-year follow-up was conducted for each patient to learn about the survival, recurrence and metastasis of patients within 5 years after treatment. Statistical analysis of the data was performed using SPSS 17.0. Results In a short time after treatment, the total effective rates of the two groups were both 100%, showing no significant difference （P〉0.05）, but significance was observed in the remission rate and partial remission rate （P〈0.01）. During the 5-year follow-up, 9 cases died and 25 cases survived in the control group, the survival cases included 4 cases of progression-free survival, 2 cases of distant metastasis, 6 cases of recurrence and 13 cases with good quality of life; in the experimental group, 4 cases died and 48 cases survived, the survival cases included 5 cases of progression-free survival, 2 cases of distant metastasis, 5 cases of recurrence and 36 cases with good quality of life. The 5-year survival rates of the two groups showed significant difference （P 〈0.01）. Conclusions When the tumor tissues are not completely removed, radiotherapy can＇t significantly improve the 5-year survival rate of patients, however, concurrent radiochemotherapy has ideal clinical curative effect. Both concurrent radiochemotherapy and radiotherapy alone have clinical effect on cervical cancer patients with poor prognosis, which can improve patients＇ survival rate and quality of life. Distant metastasis is the main reason for failing to achieve the desired results.