局部晚期宫颈腺癌与宫颈鳞癌对放化疗的反应对比

Comparative Analysis of the Chemoradiotherapy in the Local Advanced Cervical Adenocarcinoma and Cervical Squamous Cell Carcinoma

目的:对比分析局部晚期宫颈腺癌与宫颈鳞癌对放化疗的反应,加强对宫颈腺癌治疗的认识。方法:收集2001年1月-2016年12月玉林市红十字会医院进行放化疗的68例局部晚期宫颈癌患者的临床资料,其中29例为宫颈腺癌患者,39例为宫颈鳞癌患者,对患者体重、年龄、组织学分级、FIGO分期、治疗方式和预后进行回顾性分析。结果:(1)与宫颈鳞癌患者相比,宫颈腺癌对放化疗效果欠佳(分别为5.1%和31.0%;P=0.0065),更多的宫颈腺癌患者需要手术补救治疗;(2)在随后的10年中位随访期间,宫颈腺癌患者表现出更短的总生存期(宫颈腺癌为7.4年,宫颈鳞癌为11年;P=0.01);(3)宫颈腺癌与宫颈鳞癌复发率(31.0%和28.2%)和间隔无瘤期(1.2年和2年),差异无统计学意义(P=0.79、0.11)。结论:局部晚期宫颈腺癌对放化疗的反应比宫颈鳞癌差,应针对其特点制定新的治疗策略。

Objective：To compare the reaction of local advanced cervical adenocarcinoma with cervical squamous cell carcinoma to radiotherapy and to strengthen the treatment of cervical adenocarcinoma.Method：From January 2001 to December 2016,in Red Cross Hospital of Yulin City,the clinical data of 68 patients with locally advanced cervical cancer for radiation and chemotherapy were collected,of which 29 cases of cervical adenocarcinoma patients,39 cases of cervical squamous carcinoma patients,the patient body weight,age,histological grade,FIGO stage,treatment and prognosis were retrospectively analyzed.Result：Compared with patients with cervical squamous cell carcinoma,the effect of chemotherapy was not good（5.1% and 31.0% respectively,P=0.0065）,more patients with cervical adenocarcinoma require surgical remediation.In the following 10 years of follow-up,patients with cervical adenocarcinoma showed a shorter total survival（the cervical adenocarcinoma was 7.4 years and the cervical squamous cell carcinoma was 11 years,P=0.01）.The differences between cervical adenocarcinoma and cervical squamous cell carcinoma（31.0% and 28.2%）,and interval nodule（1.2 years and 2 years）,no statistically significant difference（P=0.79,0.11）.Conclusion：The effect of local advanced cervical adenocarcinoma on chemoradiotherapy is worse than that of cervical squamous cell carcinoma,and the new treatment strategy should be developed for its characteristics.