128例Ⅲ期宫颈癌患者的疗效及预后影响因素分析

Thecurative effect and influencing factors of the prognosis of 128 patients with stage Ⅲ cervical cancer

目的:探讨Ⅲ期宫颈癌患者的远期疗效及预后影响因素。方法:收集西安交通大学第二附属医院2010年3月至2012年5月收治的128例Ⅲ期宫颈癌患者的临床资料,采用单因素分析、Cox风险回归分析及Kaplan-Meier法回顾性分析影响患者预后的危险因素。结果:128例患者的中位随访时间59个月,2年和5年的总生存率分别为82. 80%和44. 50%,2年和5年的无进展生存率分别为80. 50%和40. 60%。单因素分析显示患者的5年总生存率与肿瘤直径、病理类型、治疗方式及放疗持续时间呈显著相关(all P <0. 05),差异具有统计学意义。多因素分析显示,肿瘤直径、病理类型、治疗方式及放疗持续时间均为Ⅲ期宫颈癌患者预后的独立危险因素。结论:Ⅲ期宫颈癌患者的预后与肿瘤直径、病理类型、治疗方式及放疗持续时间显著相关,在不良反应可耐受的前提下应尽量采用同步放化疗的治疗模式,并在8周内完成放疗,以进一步提高患者的总生存率。

Objective： Toinvestigate the curative effect andinfluencing factors of the prognosis of 128 patients with stage Ⅲ cervical cancer. Methods： The clinical data of 128 patients with stage Ⅲcervical cancer in our hospitalfrom March 2010 to May 2012 were collected and reviewed. Univariate linear regression,Cox regression and Kaplan-Meier method was adopted to investigate the risk factors influencing the prognosis. Results： The median followup time was 59 months. The 2-year and 5-year overall survival（ OS） rate was 82. 80% and 44. 50% respectively.The 2-year and 5-year disease-free survival（ DFS） rate was 80. 50% and 40. 60% respectively. The results of univariate analysis showed that the 5-year OS rate was related to tumor size,pathological type,therapy method and the duration of radiotherapy,with statistically significant differences（ all P〈0. 05）. The outcomes of multivariate analysis showed that tumor size,the pathological type,the therapy method and the duration of radiotherapy all were the independent risk factors for the prognosis of stage Ⅲ cervical cancer. Conclusions： The prognosis of patients with stage Ⅲ cervical cancer is significantly correlated with the tumor size,the pathological type,the therapy method and the duration of radiotherapy. In order to improve the OS rate of patients,concurrent radio-chemotherapy is recommended and the radiotherapy should be completed within 8 weeks without increasing the adverse effects.