Ⅰ_(a2)-Ⅱ_a期宫颈癌术后盆腔小野放化疗取代盆腔标准野放疗的临床探究

Clinical study on the replacement of pelvic standard field radiotherapy with small pelvic field chemoradiotherapy in stages Ⅰ_(a2)-Ⅱ_a cervical carcinoma

目的:观察采用盆腔小野放化疗与盆腔标准野放疗治疗Ⅰ_(a2)-Ⅱ_a期术后宫颈癌患者的生存率及不良反应。方法:选取2009年7月至2012年7月之间行广泛全子宫切除+盆腔淋巴结清扫后的Ⅰ_(a2)-Ⅱ_a期且具有肿瘤复发中危因素行术后治疗的宫颈癌患者,随机分为两组:盆腔小野放化疗组、盆腔标准野放疗组。比较两组患者的生存率及不良反应。结果:采用盆腔小野放化疗组、标准放疗组的4年生存率分别为97.6%、92.9%,两组间比较差异无统计学意义(P>0.05)。但在不良反应方面,盆腔小野放化疗组的直肠反应及泌尿道反应明显低于标准野放疗组,差异具有统计学意义(P<0.05)。结论:盆腔小野放化疗组与盆腔标准野放疗组的4年生存率未见明显差异,因此采用盆腔小野放化疗对行根治性手术的Ⅰ_(a2)-Ⅱ_a期宫颈癌患者中具有中度预后不良危险因素的患者是可行的,且采用盆腔小野放化疗的不良反应较标准放疗组明显低、患者生活质量明显提高。

Objective： To observe the survival rate and untoward effects of small pelvic field chemoradiotherapy and pelvic standard radiotherapy in the treatment of stages Ⅰ_（a2）-Ⅱ_a cervical carcinoma.Methods： Cervical cancer patients treated with Ⅰ_（a2）-Ⅱ_a after extensive hysterectomy and pelvic lymph node dissection were selected from July 2009 to July 2012.Patients with cervical cancer who were treated with postoperative treatment were randomly divided into 2 groups： Small pelvic field chemoradiotherapy group and pelvic standard field radiotherapy group.The survival rate and untoward effects were compared between the two groups.Results： The 4-year survival rates were 97.6% and 92.9% in the small pelvic field chemoradiotherapy and the standard radiotherapy group,respectively.There was no significant difference between the two groups（ P 0.05）.However,the rectal reaction and urinary tract reaction were significantly lower in the small pelvic field chemoradiotherapy group than in the standard field radiotherapy group（ P 0.05）.Conclusion： There is no significant difference in the 4-year survival rate between the small pelvic field chemoradiotherapy group and the pelvic standard field radiotherapy group.Therefore,the small pelvic field chemoradiotherapy is used to treat patients with Ⅰ_（a2）-Ⅱ_a cervical cancer with moderate prognosis risk factors patients is viable,and the use of small pelvic field chemoradiotherapy in the field of toxic untoward effects was significantly lower than the standard radiotherapy group,and improve the quality of life of patients.