早期宫颈癌根治术后辅助治疗126例分析

Adjuvant treatment of 126 cases of stage Ⅰb、Ⅱa cervical carcinoma after radical hysterectomy and pelvic lymphadenectomy

目的 :探讨早期宫颈癌术后辅助治疗方法的合理选择及临床价值。方法 :回顾性分析了Ⅰb、Ⅱa期宫颈癌行根治术后加用放疗或化疗辅助治疗 12 6例 ,其中单纯放疗 6 4例 ,单纯化疗 2 6例 ,放、化疗联合 36例。对其治疗结果的预后因素进行分析。结果 :12 6例总的五年生存率为 73%(92 12 6 ) ,单纯放疗组 ,单纯化疗组 ,放、化疗联合组分别为 76 .6 %(4 9 6 4) ,6 9.2 %(18 2 6 ) ,6 9.4%(2 5 36 )。临床分期及腹膜后淋巴结转移数目是最重要的预后因素。结论 :早期宫颈癌根治术后辅助治疗的价值是有限的 ,但存在 2个以上不良预后因素者 ,术后应加辅助治疗 ,同时应重视根治性手术的彻底性。

Purpose:To investigate the rational choice of adjuvant treatment and its clinical value for stage Ⅰb, Ⅱa cervical cancinoma after radical hysterectomy and pelvic lymphadenectomy.Methods:126 patients with stage Ⅰb and Ⅱa cervical cancer received adjuvant radiotherapy and/or chemotherapy after radical hysterectomy and pelvic lymphadenectomy .Of these patients, 64 received radiotherapy only, 26 chemotherapy only, 36 had both. The prognostic factors and treatment results were analyzed.Results:The overall 5-year survival rate for the 126 patients was 73%(92/126). For the radiotherapy only, chemotherapy only, and the radio-chemotherapy groups, the 5-year survival rates were 76.6%(49/64), 69.2%(18/26), and 69.4%(25/36) respectively. The clinical stages and the number of pelvic lymphnodes metastases were the most important prognostic factors. Conclusions:The value of adjuvant treatment for early stage cervical cancer after radical surgery was limited, but for patients who had more than two high risk factors, adjuvant treatment should be given, and at the same time, we should emphasis the importance of thoroughness of radical hysterectomy and pelvic lymphadenectomy.