早期宫颈癌腹腔镜手术加放疗的疗效分析  

Clinic Analysis of Laparoscopic Trachelectomy Combined with Radiotherapy in the Treatment of Early Stage Cervical Carcinoma

作　　者：胡学锋[1] 黄国森[1] 黄泽黎[1] 潘衍基[1] 陈露斯[1] 吴永锋[1] 

机构地区：[1]广东省佛山市第一人民医院肿瘤医院放疗科,528041

出　　处：《实用癌症杂志》2007年第4期393-394,共2页The Practical Journal of Cancer

摘　　要：目的探讨腹腔镜下宫颈癌根治术加术后放疗的疗效。方法回顾性分析1999年8月-2005年10月76例早期宫颈癌术后放疗的临床资料。患者均行腹腔镜下广泛全子宫及双侧附件或单侧附件（Ⅰ期年轻患者）切除术加盆腔淋巴结切除术。放疗采用体外照射和近距离（腔内）照射。体外照射常规分割放疗，2Gy/次，5次/周。总剂量42-46Gy/29-31d。除ⅠA期外，其余患者加用腔内后装治疗。4-6Gy/次，1次/周，共2-3次，总剂量12-18Gy。结果3年总生存率ⅠA期100%；ⅠB期98%；ⅡA期95.5%。CT或MRI判断3年盆腔淋巴结转移率：Ⅰ期4例（7.4%）；ⅡA期3例（13.6%）。远处转移率：Ⅰ期3例（5.6%）；ⅡA期2例（9.1%）。副作用：放射性直肠炎6例（7.9%）；阴道挛缩5例（6.6%）；外阴水肿3例（3.9%）。结论早期宫颈癌腹腔镜下手术加放疗，疗效肯定，副作用小，具有较好的临床应用价值。Objective To investigate and analyze the clinic effect of laparoscopic radical trachelectomy combined with radiotherapy in the treatment of early stage cervical carcinoma. Methods 76 patients with early stage cervical carcinoma treated by laparoscopic radical trachelectomy combined with radiotherapy between August 1999 and October 2005 were retrospectively reviewed. All patient underwent laparoscopic extensive total hysterectomy and bilateral or lateral adenecctomy and pelvic lymphadenecctomy. Adjuvant radiotherapy consisted of external beam radiotherapy 42 -46Gy/29 -31d to the pelvis, high-dose rate brachytherapy 12 - 18Gy ,4 - 6Gy per fraction, 1 fraction per week to the tumor. Results 3-year survival rates were 100%, 98% and 95.5% for stage Ⅰ A, Ⅰ B, Ⅱ A ,respectively. 3-year pelvic lymph nodes metastasis rate were 7.4% and 13.60/o for stage Ⅰ , Ⅱ A respectively. 3-year distant metastasis rate were 5.6% and 9. 1% for stage Ⅰ , Ⅱ A respectively. Major long-term local complications occurred in 16 patients ：6 cases with postradiation rectitis, 5 cases with postradiation vulvismus and 5 cases with vulval edema. Conclusion The results indicate that laparoscopic radical trachelectomy combined with radiotherapy is effective in the treatment of early stage cervical carcinoma with mild side effects.

关 键 词：宫颈肿瘤 腹腔镜 放射疗法 近距离治疗 

分 类 号：R737.33[医药卫生—肿瘤]