同步推量调强放疗联合化疗治疗局部中晚期宫颈癌的疗效和安全性

Efficacy and safety of simultaneous modulated accelerated radiotherapy plus chemotherapy in treatment of local advanced cervical cancer

目的:回顾性分析同步推量调强放疗联合化疗治疗局部中晚期宫颈癌的临床疗效和安全性。方法 :研究对象为2012年1月—2014年1月在暨南大学附属第一医院接受治疗的局部中晚期宫颈癌患者92例,其中研究组68例接受同步推量调强放疗联合紫杉醇脂质体和洛铂同步放化疗,对照组24例接受三维适形放疗联合紫杉醇脂质体和洛铂同步放化疗。比较2组的临床疗效、生存情况和安全性。结果 :研究组临床总有效率为85.29%,显著优于对照组的58.33%(P=0.022)。研究组患者的中位生存期为31个月,明显优于对照组患者的25个月。研究组患者的骨髓抑制发生率低于对照组,差异有统计学意义(P=0.041)。研究组患者的胃肠反应发生率与对照组相比,差异无统计学意义(P=0.704)。研究组患者的放射性直肠炎和膀胱炎发生率明显低于对照组,差异有统计学意义(P值分别为0.001和0.018)。结论 :同步推量调强放疗联合化疗治疗局部中晚期宫颈癌患者的疗效显著,患者耐受性较好,不良反应较轻,值得在临床上进行推广。

Objective： To evaluate the clinical efficacy and safety of simultaneous modulated accelerated radiotherapy（SMART） in patients with locally metaphase or advanced cervical cancer.Methods： Total of 92 patients with locally metaphase or advanced cervical cancer treated in First Affiliated Hospital of Jinan University from January 2012 to January 2014 were collected and the clinical medical records were retrospectively analyzed. Of 92 patients, 68 patients who received SMART combined with weekly paclitaxel liposome and lobaplatin chemotherapy were designated into study group, and 24 patients who received threedimensional conformal radiotherapy combined with weekly paclitaxel liposome and lobaplatin chemotherapy were designated into control group.The clinical efficacy, survival and the safety were compared between the two groups.Results： The overall response rate of study group was 85.29%, which was significantly higher than that of the control group（58.33%, P = 0.022）. The median survival time of the study group was 31 months, which was significantly longer than that of the control group（25 months）. The incidence rate of marrow suppression in study group was lower than that in the control group（P = 0.041）. The incidence rate of gastrointestinal reaction had no significant difference between the two groups（P = 0.704）. The incidence rates of radiation-induced rectitis and cystitis were both lower than those in the control group（P = 0.001, P = 0.018）.Conclusion： The efficacy of SMART combined with weekly paclitaxel liposome and lobaplatin chemotherapy is remarkable with tolerable adverse reactions.It is worth of further clinical application.