多西他赛联合洛铂治疗宫颈癌术后补充治疗的临床刍议及影响预后的相关危险因素分析

Clinical Analysis of Postoperative Supplementary Treatment of Docetaxel Combined with Lobaplatin in Treatment of Cervical Carcinoma and Related Risk Factors Affecting Prognosis

目的探讨多西他赛联合洛铂治疗宫颈癌术后补充治疗的临床观察,以及其预后的影响因素。方法回顾性分析该院2010年1月—2012年12月收治的40例宫颈癌患者的临床资料。应用多西他赛联合洛铂治疗,维持治疗2个周期后,评价患者临床疗效及安全性,并分析患者5年生存情况。采用Kaplan-Meier方法进行生存分析,Log-rank法检验差异性,多因素分析采用COX风险比例模型。结果至随访结束,患者临床有效率CR=16例,PR=13例,有效率72.5%,生活质量改善率=(15/40)37.5%。共有死亡患者5例(5/40,12.5%),5年总生存率为70.0%,Ib2、IIa、IIb、III期生存率分别为95.0%、85.0%、75.0%和50.0%,各分期5年生存率比较差异有统计学意义(χ~2=5.985,P=0.001)。单因素分析结果显示:淋巴结转移、分期、肿瘤残留、宫颈浸润深度、病灶大小是影响宫颈癌预后的影响因素。多因素分析结果显示:临床分期是宫颈癌预后的唯一独立影响因素。结论宫颈癌围手术期采用多西他赛联合洛铂治疗有效率达72.5%,临床分期是宫颈癌预后的唯一独立影响因素。

Objective To study the postoperative supplementary treatment of docetaxel combined with lobaplatin in treatment of cervical carcinoma and related risk factors affecting prognosis. Methods 40 cases of patients with cervical carcinoma admitted and treated in our hospital from January 2010 to December 2012 were selected, and treated with docetaxel combined with lobaplatin, and clinical curative effect and safety were evaluated after two-week treatment,and the 5-year survival conditions were analyzed, the survival analysis was analyzed by the Kaplan-Meier method, and the difference was tested by the Log-rank method, and the multi-factor analysis was used by the COX risk ratio model.Results The clinical effective rate CR =16 cases,PR =13 cases, to the end of follow-up, and the effective rate was72.5%, and the quality of life improvement rate =（15/40）37.5%, and there were 5 death cases（5/40,12.5%）, and the 5-year survival rate was 70.0%, and the survival rates of Ib2,IIa,IIb,III stages were respectively 95.0%,85.0%,75.0%,50.0%, and the difference was obvious（χ^2=5.985, P=0.001）, and the single-factor analysis results showed that the lymph node metastasis, staging, tumor residual, invasive depth of cervix, size of the lesion were the influence factors of prognosis of cervical carcinoma, and the multi-factor analysis results showed that the clinical stage was the only independent influence factor of prognosis of cervical carcinoma. Conclusion The effective rate of docetaxel combined with lobaplatin in treatment of cervical carcinoma during the perioeprative period reaches 72.5%, and the clinical stage is the only independent influence factor of prognosis of cervical carcinoma.