甘氨双唑钠联合放射和化学疗法治疗中晚期宫颈癌疗效观察

Effect of glycididazole sodium combined with radiotherapy and chemotherapy on middle and advanced cervical cancer

目的探讨甘氨双唑钠联合放射和化学疗法治疗中、晚期宫颈癌的临床效果。方法 74例中、晚期宫颈癌患者分为观察组和对照组,每组37例,2组患者均给予适形放射治疗和化学治疗,在此基础上,观察组患者给予甘氨双唑钠治疗,比较2组患者的近期治疗效果、不良反应、放射剂量及1、2、3 a生存率。结果观察组患者缓解率为75.68%(28/37),总有效率为94.59%(35/37);对照组患者缓解率为51.35%(19/37),总有效率为91.89%(34/37);观察组患者治疗缓解率显著高于对照组(P<0.05),但2组患者治疗总有效率比较差异无统计学意义(P>0.05)。观察组治疗效果达到完全缓解和部分缓解患者的中位放射剂量分别为56、36 Gy,对照组治疗效果达到完全缓解和部分缓解患者的中位放射剂量分别为66、45 Gy,观察组治疗效果达到完全缓解和部分缓解患者的放射剂量均显著低于对照组(P<0.05)。2组患者放射性膀胱炎、放射性直肠炎、胃肠道反应、骨髓抑制、心电图异常及皮肤、黏膜反应发生率比较差异均无统计学意义(P>0.05)。观察组患者1、2、3 a生存率分别为91.89%(34/37)、83.78%(31/37)和70.27%(26/37),对照组患者1、2、3 a生存率分别为89.19%(33/37)、72.97%(27/37)和59.46%(22/37),2组患者1、2、3 a生存率比较差异均无统计学意义(P>0.05)。结论中、晚期宫颈癌患者应用甘氨双唑钠进行辅助治疗,能够显著提高患者的治疗效果,降低放射剂量,且不会增加不良反应发生率;但甘氨双唑钠对中、晚期宫颈癌患者远期疗效的影响仍需进一步研究。

Objective To investigate the clinical effect of glycididazole sodium combined with radiotherapy and chemotherapy on middle and advanced cervical cancer. Methods Seventy-four patients with middle and advanced cervical cancer were divided into observation group and control group,37 cases in each group. The patients in the two groups were treated with conformal radiation therapy and chemotherapy. Based on these,the patients in observation group were treated with glycididazole sodium. The short-term treatment effect,adverse reaction,radiation dose and the survival rate of 1-year,2-year,and 3-year were compared between the two groups. Results The remission rate and total effective rate in observation group was 75. 68%（ 28 /37） and 94. 59%（ 35 /37） respectively,and in control group was 51. 35%（ 19 /37） and 91. 89%（ 34 /37） respectively. The remission rate in observation group was significantly higher than that in control group（ P 〈0. 05）,but there was no significant difference in the total effective rate between the two groups（ P 〈0. 05）. The median radiation dose of the patients of complete remission and partial remission in observation group was 56 Gy and 36 Gy respectively,and in control group was 66 Gy and 45 Gy respectively. The median radiation dose of the patients of complete remission and partial remission in observation group was significantly lower than that in control group（ P 〈0. 05）. There was no significant difference in the incidences of radiation cystitis,radiation proctitis,gastrointestinal reactions,bone marrow suppression,abnormal electrocardiogram,skin and mucous membrane reaction between the two groups（ P 〈0. 05）. The survival rate of 1-year,2-year and 3-year in observation group was91. 89%（ 34 /37）,83. 78%（ 31 /37） and 70. 27%（ 26 /37） respectively,and in control group was 89. 19%（ 33 /37）,72. 97%（ 27 /37） and 59. 46%（ 22 /37） respectively. There was no significant difference in the survival rates of 1-year,2-year and 3-year between the two groups（ P 〉0. 05）. Conclusions Adjuvant treatment with glycididazole sodium on patients with middle and advanced cervical cancer can significantly improve the therapeutic effect,reduce the radiation dose,and can not increase the incidence of adverse reaction. But the long-term effect of glycididazole sodium on middle and advanced cervical cancer still needed to be further studied.