术后放疗联合全身化疗治疗早期宫颈癌的疗效观察

Effect observation of postoperative radiotherapy combined with systemic chemotherapy in treating patients with cervical canceRin early stage

目的评估术后放疗联合全身化疗治疗早期宫颈癌的临床效果。方法回顾性分析152例Ⅰb-Ⅱa期宫颈癌术后放疗患者的临床资料,并分为放疗联合全身化疗组和单纯放疗组,每组76例。比较2组临床资料及复发转移情况。结果152例早期宫颈癌患者术后放疗后复发率为20.39%。单因素及多因素分析显示,脉管癌栓、深间质浸润、宫旁侵犯、盆腔淋巴结转移是宫颈癌术后放疗后复发的独立危险因素(P<0.05)。放疗联合全身化疗组的腺癌及其他病理类型、肿瘤直径大、有脉管癌栓、盆腔淋巴结转移比率均高于单纯放疗组,差异有统计学意义(P<0.05或P<0.01)。在88例老年(≥50岁)早期宫颈癌患者中,单因素及多因素分析显示,宫旁侵犯、盆腔淋巴结转移是老年宫颈癌患者术后放疗后复发的独立危险因素(P<0.05)。结论脉管癌栓、深间质浸润、宫旁侵犯、盆腔淋巴结转移是早期宫颈癌患者术后放疗后复发的独立危险因素。对于伴有中高危险因素的早期宫颈癌患者,术后放疗联合全身化疗有助于减少复发风险。宫旁侵犯、盆腔淋巴结转移是老年早期宫颈癌患者术后复发的独立危险因素。

Objective To evaluate the clinical effect of postoperative radiotherapy combined with systemic chemotherapy in treating patients with cervical canceRin early stage.Methods The clinical materials of 152 patients with postoperative radiotherapy in stageⅠb toⅡa of cervical canceRwere retrospectively analyzed,and they were divided into radiotherapy combined with systemic chemotherapy group and simple radiotherapy group,with 76 cases in each group.The clinical materials and conditions of recurrence and metastasis were compared between the two groups.Results In the 152 patients with cervical cancer in early stage,the recurrence rate after postoperative radiotherapy was 20.39%.Univariate and multivariate analyses showed that vascular cancer thrombus,deep interstitial infiltration,parametrial infiltration and pelvic lymph node metastasis were the independent risk factors for postoperative recurrence of cervical cancer after radiotherapy(P<0.05).In the radiotherapy combined with systemic chemotherapy group,the ratios of patients with adenocarcinoma and other pathological types,larger tumor diameter,vascular cancer thrombus and pelvic lymph node metastasis were significantly higher than those in the simple radiotherapy group(P<0.05 or P<0.01).In the 88 elderly(≥50 years old)patients with cervical cancer in early stage,univariate and multivariate analyses showed that parametrial invasion and pelvic lymph node metastasis were the independent risk factors of postoperative recurrence after radiotherapy in elderly patients with cervical cancer(P<0.05).Conclusion Vascular cancer thrombus,deep interstitial infiltration,parametrial infiltration and pelvic lymph node metastasis are the independent risk factors for postoperative recurrence after radiotherapy in patients with cervical cancer in early stage.For early cervical cancer patients with moderate to high risk factors,postoperative radiotherapy combined with systemic chemotherapy can help reduce risk of recurrence.Parametrial infiltration and pelvic lymph node metastasis are the independent risk factors of postoperative recurrence in elderly patients with cervical canceRin early stage.