刘 瑶,宋 丹,孔为民.Ⅰ~Ⅲ期宫颈癌治疗后肺转移28例临床分析[J].肿瘤学杂志,2016,22(12):1004-1008.
Ⅰ~Ⅲ期宫颈癌治疗后肺转移28例临床分析
Clinical Analysis of 28 Cases of Stage Ⅰ~Ⅲ Cervical Cancer with Pulmonary Metastasis After Treatment
投稿时间:2016-06-27  
DOI:10.11735/j.issn.1671-170X.2016.12.B005
中文关键词:  宫颈肿瘤  肺转移  治疗  预后
英文关键词:cervical neoplasms  pulmonary metastasis  treatment  prognosis
基金项目:
作者单位
刘 瑶 首都医科大学附属北京妇产医院 
宋 丹 首都医科大学附属北京妇产医院 
孔为民 首都医科大学附属北京妇产医院 
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中文摘要:
      摘 要:[目的] 探讨宫颈癌治疗后肺转移的临床特点,评价紫杉醇联合卡铂或顺铂(TC/TP方案)对宫颈癌治疗后肺转移的疗效和安全性,并分析预后影响因素。[方法] 收集28例接受TC/TP方案化疗的宫颈癌治疗后肺转移患者的临床资料,分析其临床特点,观察TC/TP方案的有效率、疾病控制率及患者的不良反应,并探讨预后影响因素。[结果] 28例患者中有16例为早期(Ⅰb~Ⅱa期)术后患者;12例为Ⅱb~Ⅲb期患者。28例患者肺转移发生时间在原发疾病治疗1~5年内。肺转移发生后TC/TP方案有效率(CR+PR)为46.4%,疾病控制率(CR+PR+SD)为60.7%,中位生存时间18个月,5年生存率10.7%,Ⅲ~Ⅳ级胃肠道反应、骨髓抑制及肾毒性发生率分别为5.0%、15.0%、0;单因素分析影响肺转移患者的预后因素,结果显示宫颈癌的病理类型、分化程度、原发肿瘤大小、肺转移灶的大小与宫颈癌肺转移患者的生存率有关(P<0.05),多因素分析显示,仅宫颈癌的分化程度是宫颈癌肺转移患者预后的独立影响因素。[结论] 要重视宫颈癌治疗后发生肺转移的问题;TC/TP方案对宫颈癌治疗后肺转移患者有效且不良反应能耐受;对于这些患者中的低分化者应加强治疗方法的研究及监测。
英文摘要:
      Abstract:[Objective] To analyze the clinical characteristics and relevant treatment of cervical cancer patients with pulmonary metastasis after the treatment. [Methods] The complete clinical data of cervical cancer patients with pulmonary metastasis after the treatment were retrospectively analyzed. Among 28 patients,16 were stage Ⅰb~Ⅱa,and 12 were stage Ⅱb~Ⅲb;pulmonary metastasis occurred within 5 years after initial treatment. All patients received TC/TP chemotherapy,the overall response rate,disease control rate and toxicity reactions of chemotherapy were observed. And the relevant prognostic factors were also analyzed. [Results] The overall response rate(CR+PR)and disease control rate(CR+PR+SD)of TC/TP chemotherapy were 46.4%,60.7%,respectively. The median survival time was 18 months,and the 5-year survival rate was 10.7%. The incidence rates of Ⅲ~Ⅳ grade of gastrointestinal reaction,bone marrow suppression and renal toxicity were 5.0%,15.0%,0,respectively. The univariate analysis showed that pathological type,differentiated degree,size of primary tumor,size of pulmonary metastasis were closely related to the prognosis(P<0.05),while only the differentiation of cervical tumor was an independent prognostic factor in multivariate regression analysis. [Conclusion] Attention should be paid to pulmonary metastasis after the treatment of cervical cancer,particularly for patients with low differentiation tumor. The TC/TP regimen is effective with tolerable toxicity,and can be widely used in patients with pulmonary metastasis after the treatment of cervical cancer.
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