年轻Ⅰb～Ⅱb期高危宫颈癌术前同步放化疗的疗效分析  

Preoperative concurrent chemoradiation effective for stage Ⅰb-Ⅱb high-risk cervical carcinoma in young females

作　　者：季成萍[1] 吴强[1] 孙志华[1] 赵一兵[1] 邵衡华[1] 

机构地区：[1]南京医科大学附属江苏省肿瘤医院妇瘤科,江苏南京210009

出　　处：《医学研究生学报》2009年第10期1056-1059,共4页Journal of Medical Postgraduates

基　　金：江苏省科技厅社会发展项目基金资助(批准号:BS2006072)

摘　　要：目的：宫颈癌的发病呈年轻化趋势,对其治疗方法的选择以及如何提高患者的生存率是目前临床研究的热点之一。文中探讨年轻Ⅰb-Ⅱb期高危宫颈癌术前同步放化疗的疗效。方法：回顾性分析118例年龄≤35岁Ⅰb-Ⅱb期宫颈癌高危患者（巨块型、分化差、非鳞癌）的治疗,根据不同的术前处理方式分为同步放化疗组、新辅助化疗组和腔内后装放疗组,治疗为相应的术前处理后行宫颈癌根治术,术后根据盆腔淋巴结转移、宫颈间质浸润深度、脉管内癌栓、组织学分化及阴道残端、切缘阳性等情况,给予化疗及放射治疗。结果：同步放化疗组癌细胞消失率、浅肌层浸润率均好于其余2组,差异有统计学意义（P〈0.05）,同步放化疗组的淋巴转移率显著低于腔内后装放疗组,差异有统计学意义（P〈0.05）,术后3年内盆腔复发率低于其他2组,而同步放化疗组的5年生存率高于其他2组,差异均有统计学意义（P〈0.05）;深肌层浸润率3组无显著性差异;手术时间、术中出血及手术并发症3组无显著差异。结论：同步放化疗是年轻Ⅰb~Ⅱb期高危宫颈癌的有效治疗手段。Objectives： The incidence of cervical carcinoma is increasing in young females.More and more clinical researches focus on the choice of therapeutic methods and improvement of the patients＇ survival.This study aimed to evaluate the efficacy of preoperative concurrent chemoradiation for stage Ⅰb-Ⅱb high-risk cervical carcinoma in young females.Methods： We retrospectively analyzed the clinical data of 118 female patients（≤35 years） with stage Ⅰb-Ⅱb high-risk cervical carcinoma,bulky,low-differentiation or non-squamous.According to preoperative treatments,the patients were divided into three groups,Group 1 preoperatively treated by concurrent chemoradiation,Group 2 by neoadjuvant chemotherapy and Group 3 by radiotherapy（intracavitary irradiation）,all followed by radical hysterectomy.And those with pathologically reported pelvic lymph node metastasis,deep cervical stromal invasion,vascular tumor thrombosis,or surgical margin positivity received postoperative chemotherapy and/or radiotherapy.Results： The disappearance rate of cancer cells and the rate of superficial myometrial invasion were significantly higher in Group 1 than in the other two groups（P〈0.05）.The rate of pelvic lymph node metastasis was significantly lower in Group 1 than in Group 3（P〈0.05）.The three-year pelvic recurrence rate was lower and the five-year survival rate was higher in Group 1 than in the other two（P〈0.05）.There were no significant differences in the deep myometrial invasion rate,operation time,blood loss and surgical complications among the three groups.Conclusion： Preoperative concurrent chemoradiation was an effective treatment for stage Ⅰb-Ⅱb high-risk cervical carcinoma in young females.

关 键 词：年轻 宫颈癌 同步放化疗 新辅助化疗 腔内放疗 

分 类 号：R737.33[医药卫生—肿瘤]