深部热疗联合同步放化疗治疗局部晚期宫颈癌的疗效分析

Efficiency of Deep Hyperthermia Combined with Concurrent Chemo-Radiotherapy for Locally Advanced Cervical Cancer

目的探讨深部热疗联合同步放化疗治疗局部晚期宫颈癌的临床疗效和毒副反应。方法将62例局部晚期宫颈癌患者随机分为单纯放化疗组30例和热疗联合放化疗组32例,均给予盆腔放疗+腔内后装治疗,化疗为顺铂联合氟尿嘧啶(PF)方案,热疗为盆腔深部热疗。治疗结束时,评价两组近期疗效;治疗后3个月,比较局部控制率和1年无瘤生存率,并观察毒副反应。结果热疗联合放化疗组总有效率显著高于单纯放化疗组,差异有统计学意义(P<0.05)。热疗联合放化疗组局部控制率及1年无瘤生存率均显著高于单纯放化疗组,差异有统计学意义(P<0.05)。两组主要毒副反应为恶性呕吐、白细胞下降、膀胱反应和直肠反应,但均未出现治疗相关性死亡。结论热疗联合放化疗能够提高局部晚期宫颈癌患者的近期疗效及局部控制率,值得临床广泛推广。

Objective To investigate the clinical effect and toxicity of deep hyperthermia combined with concurrent chemo-radiotherapy for locally advanced cervical cancer. Methods Sixty-two patients with locally advanced cervical cancer were randomly assigned to the byperthermia combined with concurrent chemo-radiotherapy group （n= 32） and simple chemo-radiotherapy group （n=30）, and were given pelvic radiotherapy plus intracavitary brachytherapy. The chemotherapy was cisplatin plus 5-Fu （PF） regimen, and byperthermia was pelvic deep hypertbermia. At the end of treatment, the near-term efficacy was evaluated in both groups. Three months after treatment, the locally controlled rates and 1-year non-tumor rates were compared, and toxicity was observed. Results The overall response rate, locally controlled rate and 1-year non-tumor rate in hyperthermia combined with concurrent chemo radiotherapy group were all significantly higher than in simple ehemo-radiotherapy group, and all differences had statistical significance. The major side effects in two groups included nausea, vomiting, decrease in white blood cells, bladder and rectum reaction, but there were no treatment-related deaths in two groups. Conclusion Hyperthermia combined with concurrent chemo -radiotherapy can improve the short-term effect and locally controlled rate of patients with locally advanced cervical cancer. This treatment regimen is worthy of being spread extensively.