宫颈癌患者腔内同步放化疗与局部感染危险因素及疗效的研究

Risk factors of local infections and efficacy of concurrent radiotherapy and chemotherapy in patients with cervical cancer

目的探讨同步放化疗治疗中晚期宫颈癌的临床效果,分析宫颈癌并发局部感染的危险因素。方法选择2010年1月-2011年1月于医院就诊的中晚期宫颈癌患者60例,随机分为观察组和对照组,各30例,对照组给予单纯放射治疗,观察组给予同步放化疗治疗,比较两组近期疗效及不良反应,随访5年,比较两组近远期疗效,分析感染相关影响因素。结果观察组近期总有效率为93.33%显著高于对照组的73.33%(P<0.05),观察组5年生存率为76.67%显著高于对照组的53.33%(P<0.05);观察组局部复发率及远处转移率分别为16.67%,13.33%显著低于对照组33.33%,26.67%(P<0.05);对照组不良反应发生率13.33%,与观察组23.33%差异无统计学意义。观察组发生局部感染20例,感染率为66.67%;住院时间>7d、合并有基础疾病、医护人员的手术不熟练、尿管留置时间>3d、未应用抗菌药物、FIGO分期IVb期是宫颈癌患者腔内放疗并发局部感染的独立危险因素(P<0.05)。结论对中晚期宫颈癌患者采取同步放化疗治疗的疗效较好,提高患者生存率,且耐受性较好。

OBJECTIVE To explore the clinical effect of concurrent radiotherapy and chemotherapy in the treatment of advanced cervical cancer,and analyze risk factors of local infections of cervical cancer.METHODS A total of 60 patients with advanced cervical cancer from Jan.2010 to Jan.2011 in our hospital were randomly divided into observation group and control group,with 30 cases in each group.Patients in control group were given radiotherapy alone,and in observation group were given concurrent radiotherapy and chemotherapy.The short-term efficacy and adverse reaction of the two groups were compared.Patients were followed up for 5 years,and the short-term and long-term efficacy between the two groups were compared.Infection related factors were analyzed.RESULTS The total efficacy in observation group was 93.33%,which was significantly higher than 73.33%in control group（P〈0.05）.The 5-year survival rate in observation group was 76.67%,which was significantly higher than 53.33%in control group（P〈0.05）.The local recurrence rate and distant metastasis rate in observation group were respectively 16.67% and 13.33%,which were significantly lower than 33.33% and 26.67%in control group（P〈0.05）.The adverse reaction rate in control group was 13.33%,compared with 23.33%in observation group,the difference was not significant.There were 20 cases of local infections in observation group,and the infection rate was 66.67%.The hospitalization time〉7 d,with underlying diseases,unskilled operation of medical personnel,catheter indwelling time〉3 d,without the use of antibiotics and FIGO stage of IVb were independent risk factors of concurrent local infections in cervical cancer patients with cavity radiotherapy（P 〈0.05）.CONCLUSION The efficacy of concurrent radiotherapy and chemotherapy for patients with advanced cervical cancer is relatively good,which can improve the survival rate of patients,and has better tolerance.