消癌平片联合CT引导的三维插植腔内后装放疗同步化疗治疗不可切除的老年局部晚期宫颈癌的临床研究

Effect of Xiaoaiping pian combined with CT image-based interstitial brachytherapy in the treatment of elderly patients with unresectable locally advanced cervical cancer

[目的]探讨消癌平片联合CT引导的三维插植腔内后装放疗同步化疗治疗不可切除的老年局部晚期宫颈癌的临床治疗效果。[方法]将162例不可切除的老年局部晚期宫颈癌患者随机分为观察组和对照组,每组81例。对照组均给予CT引导的三维插植腔内后装放疗同步化疗,观察组则在对照组基础上另给予消癌平片治疗。治疗后,评价2组近期疗效。治疗期间,密切观察2组出现的毒副作用发生率。治疗前后,检测2组外周血中IgG、IgA、CD3^+、CD4^+及CD8^+含量。治疗结束后,对患者进行为期3 a的随访,统计患者治疗1、2、3 a的生存率、无疾病进展生存时间(PFS)和总生存时间(OS)。[结果]近期疗效评价结果显示,观察组总有效率显著高于对照组(P<0.05)。治疗期间,观察组腹痛腹泻、恶心呕吐、白细胞计数降低、血小板降低、肝功能损伤、放射性直肠损伤、放射性膀胱损伤及血红蛋白降低等毒副作用发生率均显著低于对照组(P<0.05)。治疗后,观察组IgG、IgA、CD3^+、CD4^+及CD8^+均显著高于对照组(P<0.05)。远期疗效评价结果显示,观察组1 a生存率、2 a生存率、3 a生存率、平均PFS及平均OS均显著高于对照组(P<0.05)。[结论]消癌平片联合CT引导的三维插植腔内后装放疗同步化疗治疗不可切除的老年局部晚期宫颈癌疗效较好,且可有效降低毒副作用,提高患者免疫功能,延长患者生命。

[Objective] To evaluate the effect of Xiaoaiping pian combined with CT image-based interstitial brachytherapy in the treatment of elderly patients with unresectable locally advanced cervical cancer. [Methods] The 162 elderly patients were divided into observe group and control group, 81 cases in each group. Control group was treated by CT image-based interstitial brachytherapy, while the Xiaoaiping pian was given in observe group based the control group. After the treatment, the effects were observed. During the treatment, the adverse actions rates were observed in the two groups. Before and after the treatment, the levels of IgG, IgA, CD3^＋, CD4^＋and CD8^＋were detected in the two groups. After the treatment, the OS, PFS, 1 year, 2 years and 3 years survival rates were observed.[Results] In the evaluation of recent effect, the total effective rate was significantly higher in observe group than control group（ P〈0.05）.After the treatment, the levels of IgG, IgA, CD3^＋, CD4^＋and CD8^＋were significantly higher in observe group than control group（P〈0.05）.During the treatment, the rates of abdominal pain and diarrhea, nausea and vomiting, white blood cell count reduction, platelet reduction,liver function damage, radioactive rectal damage, radioactive bladder injury and hemoglobin reduction were significantly lower in observe group than control group（P〈0.05）. In long-term evaluation, the OS, PFS, 1 year, 2 years and 3 years survival rates were significantly higher in observe group than control group（P〈0.05）. [Conclusion] Xiaoaiping pian combined with CT image-based interstitial brachytherapy in the treatment of elderly patients with unresectable locally advanced cervical cancer has a good effect, could promote the immune function, remit adverse actions and extend the survival time in patients.