放、化疗联合治疗晚期宫颈癌的临床研究  

Randomized clinical trial of radiotherapy combined with chemotherapy of advanced cervical cancer.

作　　者：白明华[1] 王西京[1] 马红兵[1] 王中卫[1] 王亚利[1] 贾辉[1] 李毅[1] 许琨[1] 

机构地区：[1]西安交通大学第二医院肿瘤科,陕西西安710004

出　　处：《现代肿瘤医学》2005年第6期766-767,共2页Journal of Modern Oncology

摘　　要：目的探讨放疗与化疗何种联合方式治疗晚期宫颈癌最佳. 方法 86例Ⅲ和Ⅳ期宫颈癌患者用信封法随机分为2组,每组各43例(Ⅲ期各26例,Ⅳ期各17例)一组采用诱导化疗,另一组为同步放化疗,两组放疗方法、时间、剂量和分割均相同.外照射给予50Gy/5周,A点腔内后装治疗36～42 Gy/6～7次.诱导化疗组于放疗前先行PF方案化疗2周期,放疗在化疗结束后2周开始;同步放化疗组在放疗期间共进行PF方案化疗2周期.PF方案:顺铂 (DDP)25～30mg/m2/d,静脉注射,连用3 天;5-氟尿嘧啶(5-Fu)500 mg /m2/d,静脉滴注,连用5 天.结果放射治疗结束后3个月两组肿瘤消退相比有显著性差异(P<0.05), 诱导化疗组和同步放化疗组有效率分别为74.42%(32/43)和90.70%(39/43). 放射治疗结束后3年生存率、局部控制率, 两组相比差异有显著性(P<0.05). 诱导化疗组分别为58.14% (25/43)和65.12%(28/43),同步放化疗组分别为79.07%(34/43)和83 .72%(36/43).同步放化疗组毒副作用较诱导化疗组重,但未影响放疗进程.结论晚期宫颈癌的放、化疗联合方式中同步放化疗要优于诱导化疗.Objective To observe how to treat advanced cervical cancer with radiotherapy combined with chemotherapy. Methods Eighty - six Ⅲ and Ⅳ stage cervical cancer patients were randomly divided into the induced - chemotherapy（IC） group （ 43 patients） and the concurrent chemotherapy and radiotherapy （CCR） group （ 43 patients）. In radiotherapy , time ,close and fractionation were same. The patients who had been undergone external beam radiotherapy for 50Gy/5w and intracavitary radiotherapy for 36 -42 Gy/6 -7f. The patients of IC group were treated with PF 2 cycle chemotherapy 2 weeks before radiotherapy. The patients of CCR group were given 2 cycle chemotherapy with PF （ DDP 25 - 30mg/m^2 iv drip 3days, 5 - Fu 500mg/m2 iv drip 5 days）. Results The tumor diminution was 74.42% （ 32/43 ） in IC group and 90.70% （ 39/43 ） in the CCR group after 3 months of therapy. The difference between the IC group and the CCR group was significant （ P 〈 0.05 ）. The 3 - years survival rates were 58. 14% （ 25/43 ） in the IC group and 65.12% （ 28/43 ） in the CCR group, and the local control rate were 79.07% （ 34/43 ） in the IC group and 83 . 72% （36/43） in the CCR group and had significant difference （ P 〈 0.05 ）. The toxicity of CCR group was much more than that of IC group. Conclusion The concurrent chemotherapy and radiotherapy is prior to the induced - chemotherapy for advanced cervical cancer.

关 键 词：晚期宫颈癌 诱导化疗 同步放化疗 

分 类 号：R737.33[医药卫生—肿瘤]