新辅助化疗联合局部热疗在局部晚期宫颈癌治疗中的疗效

The efficacy of neoadjuvant chemotherapy combined with local hyperthermia for locally advanced cervical cancer

目的:探讨新辅助化疗联合局部热疗在局部晚期宫颈癌治疗中的临床疗效、放疗总时间、加速器机器跳数及不良反应。方法:选取2019年9月~2022年9月桂林市人民医院40例局部晚期宫颈癌接受新辅助化疗联合局部热疗的患者作为观察组,对本组宫颈癌患者给予2个疗程TPF方案新辅助化疗,每周期给予盆腔局部深部热疗2次;同时选取单独同期放化疗40例作为对照组;分析观察组新辅助化疗联合局部热疗的疗效、两组放射治疗总时间、加速器机器跳数及两组患者的不良反应发生情况。结果:观察组新辅助化疗联合局部热疗的客观缓解率(ORR)为87.5%(35/40),其中完全缓解(CR)为30%(12/40),部分缓解(PR)为57.5%(23/40),疾病稳定(SD)为12.5%(5/40);观察组新辅助化疗联合热疗前后肿瘤最大径分别为(5.31±1.72)cm、(2.12±1.35)cm,差异有统计学意义(t=9.401,P<0.01);观察组和对照组放射治疗时间分别为(42.15±2.75)d、(53.41±6.18)d,两组比较,差异有统计学意义(t=12.398,P<0.01);观察组和对照组外照射时单次外照射加速器机器跳数分别为(1347±129.14)MU、(1556±128.61)MU两组比较,差异有统计学意义(t=3.782,P<0.01)。结论:局部晚期宫颈癌新辅助化疗联合局部热疗患者临床治疗效果显著,新辅助化疗联合热疗后腔内后装放疗能与调强外照射放疗同时进行,缩短放疗时间,单次外照射加速器机器跳数明显减少,缩短单次治疗时间,减少加速器磨损。

Objective To investigate the clinical efficacy,total radiotherapy time,accelerator machine jumps and side effects of neoadjuvant chemotherapy combined with local hyperthermia for locally advanced cervical cancer.Method 40 patients with locally advanced cervical cancer from Guilin People′s Hospital from September 2019 to September 2022 received neoadjuvant chemotherapy combined with local hyperthermia as the observation group.The patients with cervical cancer in this group were given two courses of TPF regimen neoadjuvant chemotherapy,and local deep pelvic hyperthermia was given twice per cycle;40 patients were treated as control group with concurrent radiotherapy and chemotherapy alone;Analyze the efficacy of neoadjuvant chemotherapy combined with local hyperthermia in the observation group,the total time of radiotherapy in the two groups,the number of accelerator machine jumps,and the occurrence of adverse reactions in the two groups.Results The objective response rate(ORR)of neoadjuvant chemotherapy combined with local hyperthermia in the observation group was 87.5%(35/40),of which CR was 30%(12/40),PR was 57.5%(23/40),SD was 12.5%(5/40);The maximum diameter of the tumor in the observation group before and after neoadjuvant chemotherapy combined with hyperthermia was(5.31±1.72)cm and(2.12±1.35)cm respectively,the difference was statistically significant(t=9.401,P<0.01);The radiotherapy time of the observation group and the control group was(42.15±2.75)days and(53.41±6.18)days respectively,with significant statistical difference between the two groups(t=12.398,P<0.01);The number of machine jumps of single external irradiation accelerator in the observation group and the control group were(1347±129.14)MU and(1556±128.61)MU(t=3.782,P<0.01).Conclusion The clinical treatment effect of neoadjuvant chemotherapy combined with local hyperthermia for patients with locally advanced cervical cancer is significant.After neoadjuvant chemotherapy combined with hyperthermia,intracavitary afterloading radiotherapy can be performed simultaneously with intensity-modulated external irradiation radiotherapy,which can shorten the radiotherapy time,significantly reduce the number of machine jumps of single external irradiation accelerator,shorten the single treatment time,and reduce the wear of accelerator.