ⅡB期子宫颈癌治疗方法的探讨  

Discussion of treatments for stage ⅡB cervical carcinoma

作　　者：魏东红[1] 陈桂林[2] 田俊[1] 黄燕玲[2] 陈炜[2] 廖震华[1] 

机构地区：[1]福建医科大学流行病与卫生统计学系,福建福州350004 [2]福建省肿瘤医院妇科,福建福州350011

出　　处：《中华肿瘤防治杂志》2010年第11期857-860,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨手术综合治疗ⅡB期宫颈癌患者的临床疗效及预后影响因素。方法:选取2003-12-2005-12接受手术联合放疗和(或)化疗的ⅡB期原发宫颈癌患者75例,通过与同期住院的34例单纯放疗、54例同步放化疗患者进行生存率比较,评价手术综合治疗效果,并对可能的影响因素进行分析。结果:手术综合治疗组、单纯放疗组、同步放化疗组的1年生存率分别为96.00%、82.40%和92.60%,3年生存率分别为85.30%、67.60%和81.50%,5年生存率分别为75.50%、62.80%和79.60%。校正年龄因素后,手术综合治疗组的1年生存率高于单纯放疗组(χ2=5.975,P=0.015),与同步放化疗组相似;3、5年生存率差异无统计学意义。单因素分析结果提示,淋巴结转移、淋巴管癌栓、脉管癌栓及体质量指数与预后相关;多因素分析结果显示,淋巴结转移为其独立的危险因素,P=0.001,RR=5.936。结论:手术治疗ⅡB期宫颈癌患者是可以考虑的,淋巴结转移者预后差。OBJECTIVE： To study the clinical efficacy of the multimodality therapy of surgery for stage ⅡB cervical carcinoma and the prognostic factors.METHODS：A total of 75 patients with stage ⅡB cervical carcinoma who had surgical treatment combined with radiotherapy and/or chemotherapy during 2003.12-2005.12 were investigated,to compare the survival rates with 34 patients who had radiotherapy only and 54 patients who had concurrent chemoradiation,to assess the efficacy of surgical treatment and analyse the potential prognostic factors.RESULTS： The 1-year,3-year and 5-year survival rates of the patients who had surgical treatment,radiotherapy,concurrent chemoradiation were 96.00%,82.40%,92.60% and 85.30%,67.60%,81.50% and 75.50%,62.80% vs 79.60%,respectively.After the variable of age was adjusted,the multimodality therapy of surgery had a higher 1-year survival rate than radiotherapy（χ^2=5.975,P=0.015）and it was similar with the concurrent chemoradiation;there were no differences among three treatments in the 3-year survival rate and the 5-year survival rate.The univariate analysis revealed that lymph node metastasis,lymph vascular permeation,lymphatic permeation and BMI were related to the prognosis.Multivariate analysis showed lymph node metastasis was an independent risk factor（P=0.001,RR=5.936）.CONCLUSIONS：The multimodality therapy of surgery may be a choice for the patients with stage ⅡB cervical carcinoma.The patients with lymph node metastasis had a poor prognosis.

关 键 词：宫颈肿瘤/外科学 肿瘤分期 预后 

分 类 号：R737.33[医药卫生—肿瘤]