中晚期宫颈癌患者同步放化疗期间发生骨髓抑制的影响因素

Risk factors of myelosuppression during concurrent chemoradiotherapy in patients with advanced cervical cancer

目的研究中晚期宫颈癌患者同步放化疗期间骨髓抑制发生率及其影响因素。方法对85例宫颈癌患者的相关资料进行归纳、分析,记录同步放化疗治疗期间骨髓抑制发生情况,并统计骨髓抑制发生率;采用Logistic回归模型分析发生骨髓抑制的相关危险因素。结果85例中晚期宫颈癌患者同步放化疗期间,共发生骨髓抑制56例(65.88%)。未发生和发生骨髓抑制患者的体力状况评分、临床分期、病理类型、肿瘤直径、化疗方案、放疗方式比较,差异均有统计学意义(P﹤0.01)。经进一步非条件多因素Logistic回归分析得出,临床分期为Ⅲa~Ⅲb期、病理类型为鳞状细胞癌、肿瘤直径﹥4 cm、化疗方案为5-氟尿嘧啶+顺铂(PF方案)、放疗方式为四野+腔内均为中晚期宫颈癌患者同步放化疗期间发生骨髓抑制的独立危险因素(P﹤0.05)。结论中晚期宫颈癌经同步放化疗存在一定骨髓抑制发生率,对合并危险因素者,需要采取对应手段以保障治疗效果。

Objective To study the incidence and risk factors of myelosuppression during concurrent chemoradiotherapy in patients with advanced cervical cancer.Method The clinical data of 85 patients with cervical cancer were summarized and analyzed,the occurrence of myelosuppression during concurrent chemoradiotherapy was recorded,and the incidence of myelosuppression was also counted.The Logistic regression model was built to analyze the risk factors of myelosuppression.Result A total of 56 cases(65.88%)of myelosuppression occurred in 85 patients with advanced cervical cancer during concurrent chemoradiotherapy.There were statistically significant differences in physical status scores,clinical stages,pathological types,tumor diameters,chemotherapy regimens,and radiotherapy methods between those with and without myelosuppression(P<0.01).After further unconditional multivariate Logistic regression analysis,it was concluded that the clinical stage was Ⅲa-Ⅲb,the pathological type was squamous cell carcinoma,the tumor diameter was>4 cm,the chemotherapy regimen was 5-fluorouracil+cisplatin(PF regimen),and the radiotherapy method was four-field and intracavitary were both independent risk factors for myelosuppression during concurrent chemoradiotherapy in patients with advanced cervical cancer(P<0.05).Conclusion A certain incidence of myelosuppression may occur in advanced cervical cancer after concurrent chemoradiotherapy.Thus,corresponding measures should be taken to ensure the therapeutic effect for those with risk factors.