调强适形放疗联合紫杉醇加顺铂方案对中晚期宫颈癌患者的临床疗效及鳞状细胞癌抗原的影响

Clinical efficacy of intensity modulated radiation therapy and paclitaxel plus cisplatin regimen for patients with cervical cancer and the influence of squamous cell carcinoma antigen

目的观察调强适形放疗(IMRT)联合TP方案(紫杉醇加顺铂)对中晚期宫颈癌患者的临床疗效及其对患者血清鳞状细胞癌抗原(SCCA)的影响。方法回顾性分析福建医科大学附属宁德市医院于2012年2月至2014年2月间收治的68例中晚期宫颈鳞状细胞癌患者,根据治疗方案的不同分为IMRT+TP组(34例)和普通放疗+TP组(34例),比较两组患者的临床疗效和不良反应,以及治疗前、放疗中和治疗后的血清SCCA水平。结果 IMRT+TP组和普通放疗+TP组患者的近期治疗有效率分别为100.0%和91.2%,差异无统计学意义(P>0.05);IMRT+TP组患者的皮肤反应、直肠反应发生率均低于普通放疗+TP组(均P<0.05)。全盆外照射30 Gy后,两组患者的SCCA水平均低于治疗前(均P<0.05),且IMRT+TP组患者的SCCA水平均低于普通放疗+TP组,差异有统计学意义(P<0.05)。治疗后,两组患者SCCA水平均低于全盆外照射30 Gy后(均P<0.05),治疗后两组患者间SCCA水平的差异无统计学意义(P>0.05)。结论 IMRT联合TP方案对中晚期宫颈癌患者临床效果较好,可降低放疗后不良反应的发生率,值得临床推广。

Objective To evaluate the clinical curative effect of intensity modulated radiation therapy（ IMRT） and paclitaxel plus cisplatin（ TP） regimen for patients with cervical cancer and the influence of squamous cell carcinoma antigen（ SCCA）. Methods From Feb 2012 to Feb 2014,68 cases with advanced cervical cancer in Ningde Hospital Affiliated to Fujian Medical University were analyzed retropectively. According to the difference of treatment,they were divided into IMRT ＋ TP group and conventional radiotherapy（ CR） ＋ TP group,with each group of 34 cases. After the treatment,clinical efficacy and poor reactions of the two groups were compared,at the same time,SCCA of each group were detected before and after treatment. Results The immediate efficacy of treatment was 100. 0% in IMRT ＋ TP group,were higher than that in CR ＋ TP group（ 91. 2%）,but the difference was not significant（ P 0. 05）. The incidence of skin and rectum reactions in IMRT ＋ TP group were significant lower than that in CR ＋ TP group（ P 0. 05）. The level of SCCA in both groups was significant lower than before the treatment after exteranl exposure 30 Gy（ P 0. 05）,and the IMRT ＋ TP group was remarkable lower than the CR ＋ TP group（ P 0. 05）. The level of SCCA after treatment in both groups was significant lower than after exteranl exposure30 Gy（ P 0. 05）,but between the two groups did not have remarkable difference（ P 0. 05）. Conclusions IMRT plus TP regimen for patients with cervical canser can effectively improve the clinical efficacy and reduce the incidence rates of poor reactions. It is worth clinical promotion.