联合应用放化疗、腔内近距离治疗及热疗治疗中晚期宫颈癌的效果观察

Effect of triple therapy of chemoradiotherapy,intracavitary brachytherapy and hyperthermia on advanced cervical cancer

目的探讨联合应用放化疗、腔内近距离治疗、热疗治疗中晚期宫颈癌的效果。方法选取山西省肿瘤医院2011年7月至2016年6月收治的400例中晚期宫颈癌患者为研究对象,按照随机数字表法分为研究组与对照组,每组200例。对照组予以常规放化疗序贯腔内近距离治疗,研究组在对照组治疗基础上加用热疗。比较两组患者的临床疗效及治疗前后宫颈癌细胞中瘦蛋白、胰岛素样生长因子2(IGF2)的变化情况。治疗结束后对两组患者进行3年有效随访,记录随访期间无瘤生存、死亡等情况。结果研究组近期总有效率(74.00%,148/200)高于对照组(53.00%,106/200),差异有统计学意义(P<0.05)。两组治疗前IGF2、瘦蛋白水平比较差异未见统计学意义(P>0.05);治疗后,研究组IGF2、瘦蛋白水平低于对照组(P<0.05)。研究组3年随访期间无瘤生存率(62.00%,124/200)、病死率(5.00%,10/200)均低于对照组(30.50%,61/200;17.00%,34/200),差异有统计学意义(P<0.05)。结论放化疗、腔内近距离治疗、热疗联合应用于中晚期宫颈癌患者效果显著,有利于保障其临床近、远期疗效。

Objective To investigate the effects of triple therapy of chemoradiotherapy,intracavitary brachytherapy and hyperthermia in the treatment of advanced cervical cancer.Methods A total of 400 patients with advanced cervical cancer admitted to Shanxi Cancer Hospital from July 2011 to June 2016 were selected as the research subjects.They were divided into study group and control group according to the random number table method.Patients in the control group were treated by conventional chemoradiotherapy and intracavitary brachytherapy,and patients in the study group were treated by hyperthermia on the basis of treatment for control group.The curative effects and the changes of leptin and insulin like growth factor 2(IGF2)in cervical cancer cells before and after treatment were compared between the two groups.After treatment,patients in the two groups were followed up for 3 years,and the tumor-free survival and death of the two groups were recorded.Results The short-term total effective rate of the study group was 74.00%(148/200),higher than the 53.00%(106/200)of the control group(P<0.05).Before treatment,there was no significant difference in levels of IGF2 and leptin between the two groups(P>0.05).After treatment,the levels of IGF2 and leptin in the study group were lower than those in the control group(P<0.05).During the 3-year follow-up period,the tumor-free survival rate(62.00%,124/200)and case fatality rate(5.00%,10/200)in the study group were significantly lower than the 30.50%(61/200)and 17.00%(34/200)in the control group(P<0.05).Conclusions Triple therapy of chemoradiotherapy,intracavitary brachytherapy and hyperthermia is effective in the treatment of advanced cervical cancer,which is beneficial to the short-term and long-term clinical effect.