IMRT联合顺铂治疗宫颈癌的临床疗效及安全性研究

The clinical safety and efficacy of IMRT combined with cisplatin for patients with cervical cancer

目的:研究IMRT联合顺铂治疗宫颈癌的临床疗效及安全性。方法:回顾性随机选择在2012年8月至2013年8月我院收治的136例宫颈癌患者,并按双盲数字法将其分为对照组和观察组。对照组患者采用单一的调强放射治疗(IMRT)治疗,观察组患者在调强放射治疗(IMRT)治疗的基础上联合顺铂治疗。对患者进行定期回访3年,统计患者治疗3个月内复查结果为近期疗效及远期疗效。结果:通过对比,观察组治疗的有效率89.71%明显高于对照组治疗的有效率80.88%,差异具有统计学意义(P<0.05)。对比两组患者在治疗1年内,两组患者的生存率、局部控制率及无瘤生存率无明显差异,数据无统计学意义(P>0.05);但治疗1~3年内,观察组患者的生存率、远处转移率、局部控制率及无瘤生存率明显低于对照组,远处转移率明显低于对照组,差异对比有统计学意义(P<0.05)。观察组不良反应胃肠道反应、白细胞下降、放射性肠炎及骨髓抑制的发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论:采用IMRT联合顺铂治疗宫颈癌患者的疗效优于采用单一的IMRT治疗的患者,并减少治疗后的不良反应,值得临床推广采纳。

Objectives： To study the clinical efficacy and safety of intensity modulated radiation therapy（ IMRT） combined with cisplatin for patients with cervical cancer. Methods： 136 patients with cervical cancer were randomly selected from August 2012 to August 2013 in our hospital and divided into the control group and the observation group according to the double blind number method. Patients in the control group were treated with single IMRT,and the patients in the observation group were treated with radiotherapy combined with cisplatin on the basis of the IMRT. The patients were reviewed regularly every 3 years,and the results of the review in 3 months were found to result in short term and long term effect. Results： By contrast,the effective rate of the observation group was 89. 71%,which was significantly higher than that of the control group of 80. 88%,with statistical difference（ P〈0. 05）. Difference in the survival rate,distant metastasis rate,local control rate and disease-free survival rate between the two groups was not significant within one year after treatment（ P〈0. 05）. However,the survival rate,distant metastasis rate,local control rate and disease-free survival rate of the observation group was significant lower than the control group in 2 ~ 3 years after treatment,with statistical significance（ P〈0. 05）. The incidence of adverse reactions in the observation group including gastrointestinal reactions,white blood cells,radiation enteritis and bone marrow suppression was significantly lower than that of the control group（ P〈0. 05）. Conclusion： The efficacy of IMRT combined with cisplatin in the treatment of cervical cancer patients is better than single IMRT treatment,which can reduce the adverse reactions and worthy of clinical promotion.