Ⅰb1~Ⅱa2期宫颈癌术后不同辅助治疗疗效比较

Comparison of efficacy of different adjuvant therapies for stageⅠb1-Ⅱa2 cervical cancer after radical surgery

目的:探讨具有中高危因素Ⅰb1~Ⅱa2期宫颈癌术后不同辅助治疗的不良反应及远期疗效。方法:回顾性分析128例Ⅰb1~Ⅱa2期宫颈癌病人,其中40例接受手术+辅助放疗+顺铂(DDP)周化疗(放疗+DDP组),88例接受手术+辅助放疗+紫杉醇联合顺铂(TP)方案(放疗+TP组)。对比2组病人的不良反应及远期疗效。结果:与放疗+TP组比较,放疗+DDP组Ⅲ~Ⅳ度白细胞下降(P<0.01);Ⅲ~Ⅳ度血色素下降,Ⅲ~Ⅳ度血小板下降,Ⅲ~Ⅳ度呕吐发生率低,Ⅲ~Ⅳ度放射性直肠炎发生率低,但差异均无统计学意义(P>0.05)。2组随访时间差异无统计学意义(P>0.05)。2组复发率、5年生存率差异均无统计学意义(P>0.05)。结论:有中高危因素的Ⅰb1~Ⅱa2期宫颈癌病人术后补充放疗+顺铂周疗不良反应小、远期疗效好。

Objective:To investigate the adverse reactions and long-term effects of different adjuvant therapies for stageⅠb1-Ⅱa2 cervical cancer with intermediate and high risk factors after radical surgery.Methods:A total of 128 patients with stageⅠb1-Ⅱa2 cervical cancer were analyzed retrospectively,40 patients of which received combination of surgery,adjuvant radiotherapy and cisplatin(DDP)weekly(radiotherapy combined with DDP group),and 88 patients of which received combination of surgery,adjuvant radiotherapy,and paclitaxel combined with ODP(TP)regimen(radiotherapy combined with TP group).The adverse reactions and long-term effects of the two groups were compared.Results:Compared with radiotherapy combined with TP group,the level of gradeⅢ-Ⅳleucocytes decreased in radiotherapy combined with DDP group(P<0.01);the level of gradeⅢ-Ⅳhemachrome and gradeⅢ-Ⅳplatelet,and incidence of gradeⅢ-Ⅳvomiting and gradeⅢ-Ⅳadiation proctitis in radiotherapy combined with DDP group reduced,but the differences of which were not statistically significant(P>0.05).There was no significant difference in the follow-up time,rate of recurrence and 5-year survival rate between the two groups(P>0.05).Conclusions:The weekly radiotherapy combined with DDP therapy for stageⅠb1-Ⅱa2 cervical cancer patients with intermediate and high risk factors after radical surgery has little adverse reactions and good long-term efficacy.