紫杉醇和顺铂化疗联合调强适形放疗综合治疗老年晚期宫颈癌的临床观察

Clinical Observation of Chemotherapy with Paclitaxel and Cisplatin Combined with Intensity-modulated Radiotherapy for Advanced Cervical Cancer in the Elderly

目的探讨紫杉醇和顺铂化疗联合调强适形放疗对老年晚期宫颈癌患者生活质量、免疫功能以及临床疗效影响,为有效治疗老年晚期宫颈癌提供方法。方法选取2013年5月—2015年5月在陕西汉中3201医院肿瘤科治疗的老年晚期宫颈癌患者124例,按照数字表法随机分为观察组(n=62)和对照组(n=62)。对照组只给予调强适形放疗,观察组在与对照组相同的调强适形放疗基础上加用紫杉醇和顺铂化疗,3周为1个疗程,2组均连续治疗2个疗程。评估并比较2组生活质量、免疫功能、近期疗效和远期疗程情况。结果治疗前2组生活质量评分无显著差异(P>0.05);治疗后,2组认知功能、情绪功能、社会功能、躯体功能和自觉功能评分均比治疗前显著升高,且观察组明显高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组免疫功能无显著差异(P>0.05);治疗后,观察组CD3+、CD4+和CD4+/CD8+水平均显著高于对照组(P<0.05)。观察组临床有效率显著高于对照组(83.9%vs 64.5%,P<0.05)。观察组2年生存率和3年生存率均显著高于对照组(P<0.05);观察组局部复发率和远处转移率均显著低于对照组(P<0.05)。结论紫杉醇和顺铂化疗联合调强适形放疗综合治疗老年晚期宫颈癌,疗效明显,可改善患者的生活质量,对免疫功能影响较小,具有一定的临床应用价值。

Objective To discuss the impact of chemotherapy with paclitaxel and cisplatin combined with intensitymodulated radiotherapy on the quality of life, immune function and curative effect in the elderly with advanced cervical cancer. Methods 124 elderly with advanced cervical cancer were selected during the period from May, 2013 to May, 2015 and randomly divided into 2 groups: observation group and control group, 62 in each;intensity-modulated radiotherapy was given to the elderly in both groups while chemotherapy with paclitaxel and cisplatin was added to the elderly in observation group;1 course covered 3 weeks and the elderly in the 2 groups both underwent 2 courses;a comparative evaluation was made to the quality of life, immune function, the short-termand long-termcurative effect between the 2 groups. Results Before treatment there existed no obvious difference in the scores of the quality of life between the 2 groups (P>0.05);after treatment, the scores of cognitive function, emotional function, social function, physical function, and conscious function in both groups after treatment were obviously higher than those before treatment ( P<0.05) and the increase in observation group was even greater than that in control group (P <0.05);before treatment, no significant difference was found in immune function between the 2 groups ( P>0.05) while after treatment, the levels of CD3+, CD4+, CD4+/CD8+in observation group were much higher than those in control group ( P<0.05);the total effect rate in observation group was much higher than that in control group (83.9% vs. 64.5%, P<0.05);the 2-year survival and 3-year survival rates in observation group were greatly higher than those in control group (P<0.05) while the local recurrence rate and distant metastasis rate in observation group were much lower than those in control group ( P<0.05). Conclusions Chemotherapy with paclitaxel and cisplatin combined with intensity-modulated radiotherapy is of obvious curative effect on advanced cervical cancer in the elderly, it can improve the quality of life and produce less impact on immune function;it is of certain clinical application value.