215例老年宫颈癌的临床分析  

Clinical analysis of 215 elderly patients with cervical cancer

作　　者：程敏[1] 吴令英[1] 章文华[1] 黄曼妮[1] 张蓉[1] 

机构地区：[1]中国医学科学院肿瘤医院妇瘤科,北京 100021

出　　处：《中华肿瘤杂志》2009年第5期388-391,共4页Chinese Journal of Oncology

摘　　要：目的探讨老年宫颈癌的临床特点、治疗效果以及影响预后的因素。方法回顾性分析215例年龄≥65岁的老年宫颈癌患者的临床资料。215例患者中，192例为Ⅱb-Ⅳ期的中晚期患者，占89．3％；8例（3．7％）行手术治疗，其中6例术后辅以体外放疗；207例（96．3％）采用放射治疗，其中74例采用同步放化疗。结果全组患者总的5年生存率为63．7％，Ⅰ、Ⅱ、Ⅲ和Ⅳ期患者的5年生存率分别为83．2％、76．4％、39．0％和0。同步放化疗者与单纯放疗者的5年生存率分别为54．1％和59．6％，差异无统计学意义（P=0．4880）。多因素分析表明，临床分期、组织学分级、病理类型以及有无淋巴结转移是影响老年宫颈癌患者预后的独立因素（均P〈0．05）。结论对于老年宫颈癌患者，治疗宜个体化，应根据患者的具体情况选择合适的治疗方式，尽量选取一种根治手段，不建议综合治疗。Objective To investigate the clinical features, treatment outcomes and possible prognostic factors in elderly patients with cervical cancer. Methods Clinical data of 215 elderly women （≥65 years old） with cervical cancer were retrospectively analyzed. Most patients （ 89.3% ） had advanced stage （Ⅱ b-Ⅳ ） disease. Eight of the 215 patients （ 3.7% ） underwent surgical treatment, and six of those received postoperative radiotherapy. 133 patients received radiotherapy alone, and 74 patients underwent concurrent chemotherapy and radiotherapy. Results The median follow-up time was 48 months （ range ： 12- 102 months）. The overall 5-year survival rate was 63.7%. The 5-year survival rate for stage Ⅰ , Ⅱ , Ⅲ, IV were 83. 2% , 76. 4 %, 39. 0% and 0, respectively. There was no significant difference in 5-year survival rate between patients treated with concurrent chemotherapy combined with radiotherapy and radiotherapy alone. In multivariate analysis, lymph node metastasis, advanced stage, non-squamous histologies and poor differentiation were all negative prognostic factors for the overall survival. Condlusion The treatment strategy for elderly cervical cancer patients should be individually planned according to the disease stage and performance status of the patients. Usually, one radical therapy modality can be chosen, and combined modality therapy is not suggested.

关 键 词：宫颈肿瘤 老年人 放射疗法 外科学 预后 

分 类 号：R686[医药卫生—骨科学]