子宫颈癌术前放疗113例远期疗效分析

Results of 113 patients with cervical carcinoma treated by preoperative radiotherapy

目的对术前给于放疗的１１３例早期宫颈癌进行了远期疗效分析，并与单纯手术、单纯放疗作了同期别比较，观察有无临床意义。材料与方法本院于１９８５年至１９９２年对早期宫颈癌给于术前放疗１１３例，其中Ⅰ期３１例，Ⅱ期８２例，放疗方法为６０Ｃｏ全盆外照射，１３７Ｃｓ腔内照射或外照加腔内照射同时进行。结果生存５年以上者９２例。５年生存率为８１．４％，其中Ⅰ期２６／３１为８３．９％，Ⅱ期６６／８２为８０．５％，与国内外报道的平均水平比较，Ⅰ期、Ⅱａ期未能提高疗效，Ⅱｂ期与单纯放疗组疗效相近，比单纯手术组可提高疗效。（５年生存率７８．０％∶５９．０％）。结论Ⅰ期、Ⅱａ期患者行术前放疗无临床意义。Ⅱｂ期不宜单纯手术，术前放疗当给３０～４０Ｇｙ或单纯放疗为好。

Purpose To evaluate the efficacy of the preoperative radiotherapy for cervical carcinoma.Materials and Methods From 1985 through 1992,113 patients with cervical carcinoma were treated by preoperative radiotherapy followed by surgery.Among them,31 cases were in stage Ⅰ,82 cases in stage Ⅱ.The whole pelvis external irradiation,brachytherapy or the both was used.Results The 5year survival rates in stage Ⅰ and stage Ⅱ were 83.9% (26/31) and 80.5% (66/83),respectively. The results were not improved when compared to the results reported from others by radiotherapy alone or surgery alone. Conclusion It is considered that preoperative radiotherapy does not give advantage for the patients with cervical carcinoma in stage Ⅰ and stage Ⅱ.However ,radiotherapy alone or pre-operative irradiation of 30～40 Gy is useful for stage Ⅱb lessons.