TC化疗联合放疗治疗术后高危子宫内膜癌的疗效观察

Clinical observation of TC chemotherapy combined with radiotherapy in treatment of high-risk endometrial cancer after surgery

目的探究TC化疗联合放疗治疗术后高危子宫内膜癌的临床疗效及毒副反应。方法:选取2008年2月—2009年2月无锡市第四人民医院收治的术后高危子宫内膜癌患者82例,随机分为对照组(41例)和治疗组(41例)。对照组术后行放射治疗,治疗组术后行TC化疗方案联合放疗。计算两组患者肿瘤的复发率、生存率以及药物的毒性作用发生情况。结果:治疗组阴道、盆腔复发率,腹膜后淋巴结、肺的远处转移率均显著低于对照组,两组比较差异有统计学意义(P<0.05)。治疗组5年生存率高于对照组,两组比较差异有统计学意义(P<0.05)。治疗过程中,两组患者均可发生皮肤反应、胃肠道反应(包括恶心、呕吐、腹泻)、骨髓抑制、神经毒性、泌尿系统毒性反应等,其中,治疗组骨髓抑制发生率高于对照组,两组比较差异有统计学意义(P<0.05)。结论:TC化疗联合放疗治疗术后高危子宫内膜癌是一种有效的治疗方式,局部复发率、远处转移率以及5年生存率均明显优于单纯放疗方案,但联合治疗的骨髓抑制作用明显,需密切关注患者血细胞水平,必要时辅以造血因子进行治疗。

Objective To investigate the clinical effect and toxicity of TC chemotherapy combined with radiotherapy in treatment of high-risk endometrial cancer after surgery. Methods Patients（82 cases） with high-risk endometrial cancer after surgery who came to the Fourth People＇s Hospital of Wuxi City from February 2008 to February 2009 were randomly divided into control（41 cases） and treatment（41 cases） groups. The patients in the control group were given radiotherapy after surgery, while the patients in the treatment group were given TC chemotherapy combined with radiotherapy. The rates of tumor recurrence and survival in the two groups were calculated, and the toxic effects of drugs were observed. Results The recurrence rate of vagina and pelvic, and the distant metastasis rate of retroperitoneal lymph nodes and lung in treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Five year survival rate of the treatment group was higher than that of control group, with significant difference between two groups（P〈0.05）. Toxicity reaction such as skin reaction, gastrointestinal reaction（included nausea, vomiting, diarrhea）, bone marrow suppression, neurotoxicity, and urinary tract reaction happened in two groups during the course of treatment. The rate of bone marrow inhibition in the treatment group was higher than that in the control group, with significant difference between two groups（P〈0.05）. Conclusion TC chemotherapy combined with radiotherapy is an effective treatment for high-risk endometrial cancer after surgery, and the local recurrence rate, distant metastasis, and five year survival rate are significantly better than pure radiotherapy. But the combination treatment has the disadvantage of bone marrow suppression, the blood cell levels of the patients needs to be paid close attention, and hematopoietic factor should be complementally used when necessary.