影响子宫内膜癌术后放疗疗效的相关因素分析  

Correlative Factor Analysis of Postoperative Radiotherapy for Endometrial Cancer

作　　者：徐晓颖[1] 邵卫仙[1] 李国权[1] 李杰[1] 

机构地区：[1]大连医科大学附属二院肿瘤放疗科,116023

出　　处：《实用癌症杂志》2010年第6期652-656,共5页The Practical Journal of Cancer

摘　　要：目的探讨影响子宫内膜癌术后放疗疗效的相关因素。方法对74例手术后子宫内膜癌患者,应用6-MVX线加速器盆腔照射,4500～5000cGy/4.5～5周,外照射后均联合192Ir腔内后装治疗。参考点:阴道黏膜下0.5cm。DT16～20Gy,每次4～5Gy,每周1～2次。结果子宫内膜癌手术后联合放疗2年总生存率(OS)和无病生存率(DFS)分别为91.9%和81.1%,其中ⅠB～ⅡB期患者2年DFS为90.7%。子宫内膜癌手术后联合放疗2年内阴道复发率和盆腔复发率分别为8.1%和6.8%,远处转移率为9.5%。单因素分析淋巴结转移和病理分期明显影响子宫内膜癌患者的2年OS;淋巴结转移、病理分期、病理类型、年龄明显影响子宫内膜癌患者的2年DFS。多因素分析淋巴结转移明显影响子宫内膜癌患者的2年OS,病理类型和淋巴结转移明显影响子宫内膜癌患者的2年DFS。Ⅲ期病例术后单纯放疗和放疗联合化疗比较,2年OS和DFS无统计学差异。结论子宫内膜癌以手术治疗为首选治疗方法,根据手术及术后病理检查的结果,对病变范围及影响预后相关危险因素进行全面评估,从而制定最佳的治疗方案,对子宫内膜癌患者进行个体化的治疗已成为当前的总趋势。Objective To investigate the correlative factors associated with therapeutic effect of postoperative radiotherapy for endometrial cancer.Methods After operation,all 74 patients were given whole pelvis radiation at a dose of 4 500-5 000 cGy in 4.5-5 weeks and HDR 192Ir intracavitary brachytherapy of 16-20 Gy in 4-5 Gy per fraction,1-2 fractions per week.The reference point of brachytherapy was 0.5 cm from the vaginal mucosa.Results 2 year overall survival（OS） and disease free survival（DFS） were 91.9% and 81.1%.The 2 year DFS was 90.7% in patients withⅠB toⅡB disease.The vaginal relapse,pelvic recurrence distant metastasis rate were 8.1%,6.8% and 9.5%,respectively.Single factor analysis showed that lymph node metastasis and pathologic stage significantly affect the 2 year OS,and lymph node metastasis,pathological stage,pathological type,and age significantly influence the 2 year DFS.Multiariate analysis showed that lymph node metastasis significantly affect the 2 year OS;pathologic types and lymph node metastasis obviously influence the 2 year DFS.The OS and DFS were not significantly different between the patients treated by postoperative radiotherapy alone and those treated by the combined chemoradiotherapy.Conclusion Surgery was the primary therapy for endometrial cancer.Postoperative treatment should be based on the comprehensive analyses of the pathological examination,stage and prognostic factors.

关 键 词：子宫内膜癌 外照射 后装腔内放疗 疗效 

分 类 号：R737.33[医药卫生—肿瘤]