宫颈癌同步放化疗与单纯放疗的近期疗效及相关因素分析

Correlation analysis of short-term effect of concurrent radiochemotherapy compared with radiotherapy alone in cervical cancer

关键词:  宫颈癌  同步放化疗  近期疗效  不良反应

Key words:  cervical cancer  concurrent radiochemotherapy  short-term efficacy  toxicity

摘要:

［目的］研究同步放化疗治疗宫颈癌的近期疗效及不良反应，为宫颈癌的治疗提供临床依据。［方法］回顾性分析大连医科大学附属第二医院肿瘤放疗科收治的Ⅱ～Ⅲ期宫颈癌患者113例，分为单纯放疗组（57例）与同步放化组（56例）。同步放化组给予单药顺铂化疗。对两组的近期疗效进行整体和分层分析，并对于不良反应进行分组分析。［结果］两组患者临床情况比较，差异无显著性意义（P>0.05）。治疗后3个月时的有效率及完全缓解率较治疗刚结束时明显增加，差异有显著性意义（P<0.05），同步放化组的有效率及完全缓解率（94.6%，78.6%）明显好于单放组（84.2%，56.1%），差异均有显著性意义（P<0.05）。根据病理类型、大体分型及分期分层后，治疗后3个月时的有效率均较治疗结束时增加，同步放化组的有效率均高于单放组的有效率，差异有显著性意义（P<0.05）。同步放化组不良反应发生率均高于单纯放疗组（P<0.05），但经治疗后患者均可耐受。［结论］宫颈癌顺铂同步放疗的近期疗效优于单纯放疗，不良作用可耐受。病理类型、大体分型和分期是治疗疗效的预测因素。对疗效的评价应以治疗后3个月为佳。

Abstract:

［Objective］To study the short-term effect and the toxicity of concurrent radiochemotherapy for cervical cancer, and to provide clinical basis for treatment of cervical cancer.［Methods］Ⅱand Ⅲ stage cervical cancer patients (113 cases) in our hospital were analyzed retrospectively.They were divided into radiotherapy alone group (57 cases) and concurrent radiochemotherapy group (56 cases).Concurrent radiochemotherapy group was given cisplatin.Overall and stratified analysis of efficacy and toxicity was performed between two groups.［Results］The clinical features between two groups had no significant difference (P>0.05).The effective rate and complete remission rate were significantly increased in the 3rd month after the end of therapy compared with that at the time that the therapy just ended (P<0.05).The effective rate and the complete remission rate of concurrent radiochemotherapy group were higher than them in the monoradiotherapy group (94.6% vs 84.2%,78.6% vs 56.1%,P<0.05).According to pathology and gross type and clinical stage,patients in the two groups were stratified.The effective rates in subgroups in the 3rd month after the end of therapy were significantly in-creased compared with that at the time that the therapy just ended (P<0.05). The effective rates in subgroups of concurrent radiochemotherapy were higher than that of monoradiotherapy (P<0.05). The toxicity of concurrent radiochemotherapy group was higher than that of radiotherapy alone group (P<0.05). However, patients can tolerate the adverse reactions and complete the treatment process. ［Conclusion］The short-term efficacy of concurrent radiochemotherapy is better than radiotherapy alone in the treatment of cervical cancer, and the toxicity of concurrent radiochemotherapy is higher than that of radiotherapy alone. However, the adverse reactions can be tolerated. Pathology and gross type and clinical stage were predictors of treatment effect. The treatment should be evaluated 3 month later.