Ⅱ、Ⅲ期子宫颈癌放疗后2年内267例死因探讨  

APPROACH OF DEATH CAUSES OF CERVICAL CARCIONMA WITH STAGE Ⅱ AND Ⅲ WITHIN 2 YEARS AFTER RADIOTHERAPY: ANALYSIS OF 267 CASES

作　　者：盛修贵[1] 侯晓彤[1] 李慧芹[1] 王忠漳 孙建衡[3] 

机构地区：[1]山东省肿瘤防治研究院妇科,济南250117 [2]淄博周村区医院妇产科 [3]中国医学科学院肿瘤医院妇瘤科

出　　处：《肿瘤》2000年第1期48-50,共3页Tumor

摘　　要：目的　探讨Ⅱ、Ⅲ期子宫颈癌患者放疗后2 年内死亡的首发原因及改进治疗的对策。方法　对山东省肿瘤防治研究院妇瘤科自1985 年初至1996 年6 月经单纯放射治疗后2 年内死亡的267例子宫颈癌患者的临床资料进行回顾性分析并复习有关文献。结果　全部患者均采用规范、全量盆腔体外照射+ 后装治疗,患者年龄30～75 岁,中位年龄52.7 岁。治疗后2 年内死亡的首发原因为局部未控及复发者122 例,占45.7 % ;盆腔未控及复发者56 例,占21.0 % ;远处转移者71 例,占26.6 % ,死于放疗并发症者18 例,占6.7 % 。结论　Ⅱ、Ⅲ期子宫颈癌患者治疗后近期内死亡原因以局部未控、复发多见,其次为远处转移,预后与年龄无明显相关。治疗剂量达常规量后再增加放疗剂量并不能提高局部或盆腔控制率,所以应重视综合疗法在高危型宫颈癌中的应用。放射性直肠炎、膀胱炎与后装治疗剂量有直接关系。Objective To approach the primary death causes of cervical carcinoma with stage Ⅱ and Ⅲ within 2 years after radiotherapy and the strategy of improving the therapeutic modalities.Methods The clinical and pathological data of 267 cases were studied retrospectively. Results All patients received regular and full dose of external irradiation combined with intracavitary after loading treatment. The medial age was 57.7(30～75). The primary death causes within 2 years following radiotherapy were as follows:local persistence or recurrence,122 cases (45.7 %);pelvic persistence or recurrence 56 cases (21.0 %);distant metastasis 71 cases (26.6 %); and severe complications, 18 cases (6.7 %). Conclusion Local persistence or recurrence and distant metastasis were the main death causes for cervical carcinoma with stage Ⅱ and Ⅲ in this study. The prognosis was not related with incidence age. Local and pelvic control rate could not be improved by raising intracavitary irradiation dose after the point A was given full dose,so combination therapy should be paid attention to high risk cervical carcinoma. Cystitis and rectitis after radiotherapy were closely related with the dose of point A,so the dose should be controlled within regular range.$$$$

关 键 词：宫颈癌 放射疗法 死亡原因 

分 类 号：R737.330.5[医药卫生—肿瘤]