中晚期宫颈癌患者同步放化疗中临床病理因素的分析

Analysis of Clinical/Pathological Factors on Clinical Outcomes in Patients with Advanced Cervical Cancer Experiencing Radiotherapy Combined with Chemotherapy

目的：探讨影响中晚期宫颈癌同步放化疗效果的临床病理因素。方法：对126例接受同步放化疗的中晚期宫颈癌患者进行随访，记录患者年龄、国际妇产科联盟（FIGO）分期、病理类型、肿瘤分级、肿瘤大小、无进展生存情况、总生存情况等，并分析各因素对生存情况的影响。结果：截至随访结束共79例患者存活，总生存率为62．7％，无进展患者77例，无进展生存率为61．1％。中位随访时间45个月，随访时间8～69个月。无进展生存、总生存患者比例在不同年龄组、肿瘤分级、FIGO分期水平间差异有统计学意义（P〈0．05）。Cox回归分析显示，肿瘤分级与无进展生存有关（P〈0．05），肿瘤分级、FIGO分期对患者的总生存均有影响（P〈0．05）。不良反应包括骨髓抑制（21．4％）、胃肠道反应（16．7％）、肾功能损害（6．3％）。结论：在中晚期宫颈癌患者同步放化疗过程中，肿瘤分级和FIGO分期较高的患者治疗效果较差，未来临床工作中应予以足够重视。

Objective：To investigate the effect of clinical and pathological factors on the clinical outcomes in those patients with the advanced cervical cancer who were experiencing the combined therapy with radiotherapy and chemotherapy. Metbods：A total of 126 patients with the advanced cervical cancer who were receiving the radiotherapy combined with cisplatin were followed up for five years. Effect of those factors, such as FIGO stage, histological type, tumor grade and tumor size, on the survival rate was analyzed. Results：At of the end of the follow-up, 79 patients survived, and the five-year survival rate was 62.7%. 77 patients were in progression-free survival, the progression-free survival rate was 57.1%. The median follow-up was 45 months （Range=8-69）. There were significant differences in the progression-free survival and the overall survival after the stratification analysis by age, level of tumor grade and FIGO classification. The Cox regression analysis showed that the tumor grade was significant related to the progression-free survival （P〈0.05）; and that the tumor grade and FIGO grade had a significant impact on overall survival （P〈0.05）. Adverse event included bone marrow suppression （21.4%）, gastrointestinal reaction （ 16.7% ） and kidney dysfunction （6.3%）. Conclusions： Those patients with the advanced cervical cancer who have higher tumor grade and FIGO stage could have poor clinical outcomes of the combined therapy with radiotherapy and chemotherapy. The lower survival rate in those patients should he attended in clinical practice.