中晚期宫颈癌同步或序贯放化疗的疗效观察

Efficacy of concurrent versus sequential chemoradiotherapy in patients with intermediate and advanced cervical cancer

目的探讨中晚期宫颈癌患者接受放化疗联合疗法的效果。方法选取2012年2月至2014年2月间武汉科技大学附属孝感医院收治的60例中晚期宫颈癌患者进行回顾性研究,依据放化疗联合疗法不同分为同步放化疗组和序贯放化疗组,每组30例。同步放化疗组采用同步放化疗治疗,序贯放化疗组采用序贯放化疗治疗,对两组患者的临床疗效、不良反应发生情况、远处转移、局部复发及4年生存情况进行比较。结果两组患者的总缓解率比较,差异无统计学意义(P>0.05)。同步放化疗组患者的消化道反应和骨髓抑制发生率为73.3%和66.7%,均高于序贯放化疗组的56.7%和53.3%,差异均有统计学意义(均P<0.05)。同步放化疗组患者的远处转移率和局部复发率为3.3%和3.3%,均低于序贯放化疗组的13.3%和16.7%,差异均有统计学意义(均P<0.05)。同步放化疗组患者的4年生存率为83.3%,高于序贯放化疗组的70.0%,差异有统计学意义(P<0.05)。结论中晚期宫颈癌患者采用同步放化疗与序贯放化疗效果相当,同步放化疗的远处转移率和局部复发率低,4年生存率高,不良反应较明显。

Objective To observe the efficacy of concurrent versus sequential chemoradiotherapy in patients with intermediate and advanced cervical cancer. Methods Sixty patients with intermediate and advanced cervical cancer treated at Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from February 2012 to February 2014 were selected and retrospectively studied. These patients were divided into a concurrent chemoradiotherapy group and a sequential chemoradiotherapy group with 30 patients in each group according to the different therapies they received. The clinical efficacy,adverse effects,distant metastasis,local recurrences and 4-year survival were analyzed statistically in the two groups. Results There was no significant difference in the overall response rate between the two groups（ P〉 0. 05）. The incidence of digestive tract reactions,and myelosuppression was 73. 3% and 66. 7% respectively in the concurrent chemoradiotherapy group which were significantly higher than 56. 7% and 53. 3% respectively of the sequential chemoradiotherapy group（ all P〈 0. 05）. The distant metastasis rate and local recurrence rate was 3. 3% and 3. 3% respectively in the concurrent chemoradiotherapy group which were significantly lower than 13. 3% and 16. 7% respectively of the sequential chemoradiotherapy group（ all P〈 0. 05）. The 4-year survival rate 83. 3% for the the concurrent chemoradiotherapy group which was significantly higher than70. 0% of the sequential chemoradiotherapy group（ P〈 0. 05）. Conclusion The efficacy of concurrent chemoradiotherapy and sequential chemoradiotherapy is similar in patients with intermediate and advanced cervical cancer. However,the distant metastasis rate and local recurrence rate were low for concurrent chemoradiotherapy and the 4-year survival rate and adverse reactions were higher.