| 高 楠,李大鹏,盛修贵.早期宫颈癌术后伴高危复发因素患者不同治疗方式疗效和并发症的观察[J].肿瘤学杂志,2017,23(4):312-316. |
| 早期宫颈癌术后伴高危复发因素患者不同治疗方式疗效和并发症的观察 |
| The Effectiveness and Complications of Different Treatment Modalities After Surgery for Early-Stage High Risk Cervical Carcinoma |
| 投稿时间：2016-11-29 |
| DOI：10.11735/j.issn.1671-170X.2017.04.B012 |
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| 中文关键词: 宫颈癌 放射治疗 化疗 同步放化疗 疗效 并发症 |
| 英文关键词:cervical carcinoma radiotherapy intracavitary radiotherapy chemotherapy concurrent chemoradiotherapy effectiveness complications |
| 基金项目:泰山学者（NO.ts201511073）；山东省医药卫生科技发展计划项目（2014WS0324） |
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| 中文摘要: |
| 摘 要：［目的］ 观察同步放化疗不同化疗方案应用于宫颈癌术后伴有高危复发因素患者的疗效、并发症。［方法］ 回顾性分析2008年1月至2013年3月山东省肿瘤医院收治的经术后病理证实伴有1个或多个高危不良预后因素、接受单纯放疗或同步放化疗治疗且具备完整临床病理资料的早期宫颈癌患者327例，其中接受单纯放疗（调强放射放疗+腔内放疗）者53例，接受同步放化疗（调强放射治疗+腔内放疗+化疗）者274例，后者根据化疗方案不同分为FP方案（5-氟尿嘧啶+顺铂）+IMRT+腔内放疗组（96例）、TP方案（紫杉醇+顺铂）+IMRT+腔内放疗组（91例）、PEB方案（顺铂+依托泊甙+博来霉素）+IMRT+腔内放疗组（87例），比较4组患者的治疗效果和相关并发症发生情况。［结果］ 随访时间为39~99个月，中位随访时间46个月。单纯放疗组、FP方案+放疗组、TP方案+放疗组、PEB方案+放疗组3年无瘤生存率分别为66.0％、80.2％、84.6％、81.6％，差异有统计学意义(χ2=8.959，P=0.03)；3年总生存率分别为71.7％、85.4％、87.9％、83.9％，单纯放疗组和同步放化疗组比较差异均有统计学意义（P＜0.05），但同步放化疗3组间差异无统计学意义（P＞0.05）。4组患者慢性放疗毒副反应发生率差异无统计学意义（P＞0.05）。［结论］ 对于早期高危宫颈癌患者，术后采用同步化疗+IMRT+腔内放疗可取得理想的治疗效果，不同化疗方案之间疗效及相关并发症发生率相当，但三联方案并发症发生率稍高。 |
| 英文摘要: |
| Abstract：［Objective］ To compare the effectiveness and side effects of concurrent chemoradiotherapy and radiotherapy for postoperative therapy on high risk early-stage cervical carcinoma. ［Methods］ A total of 327 patients with high risk early-stage cervical carcinoma at Shandong Cancer Hospital & Institute between January 2008 and March 2013 were enrolled in the study，53 received intensity modulated radiotherapy(IMRT)+intracavitary radiotherapy(ICRT)；274 were given concurrent chemoradiotherapy(CCRT，chemotherapy+IMRT+ ICRT)，but with different regimens，96 were treated with FP(5-fluorouracil+cisplatin)，91 were treated with TP(taxol+cisplatin，TP group)，and 87 with PEB (cisplatin+etoposide+bleomycin，PEB group). Disease-free survival（DFS），treatment effects and complications of different groups were compared. ［Results］ The follow-up time was 39-99 months，with a median follow-up of 46 months. The 3-year disease-free survival rates of RT alone group，FP group，TP group，PEB group were 66.0%，80.2%，84.6%，81.6%，respectively. There were significant differences in 3-year DFS rates (χ2=8.959，P=0.03). The 3-year overall survival rates of RT alone group and 3 CCRT groups were 71.7％，85.4％，87.9％，83.9％ respectively.There were also significant differences in 3-year overall survival rates(χ2=6.934，P=0.0085)，but no significant differences among the 3 CCRT groups(P＞0.05). The frequencies of chronic grade radiation toxicities of the 4 CCRT groups were equivalent(P＞0.05). ［Conclusions］ CCRT have the encouraging 3-year DFS rate，though with some complications of the therapy，CCRT is the better choice for high risk early-stage cervical carcinoma. |
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