年轻妇女巨块型宫颈癌患者不同治疗方案的生存质量比较  

Comparison of the quality of life after different treatments for young women patients with bulky cervical cancer

作　　者：韩娜娜[1] 王娟[1] 张晶[1] 金华[1] 

机构地区：[1]新疆维吾尔自治区乌鲁木齐市新疆医科大学附属肿瘤医院妇科,乌鲁木齐830011

出　　处：《山西医科大学学报》2014年第9期849-852,共4页Journal of Shanxi Medical University

基　　金：新疆维吾尔自治区自然科学基金资助项目(2011211A093)

摘　　要：目的 探讨年轻妇女巨块型（Ⅰ B2、ⅡA2期）宫颈癌患者不同治疗方案的疗效. 方法 选择2006-02 ～ 2010-01在我院住院治疗的158例巨块型（Ⅰ B2、ⅡA2期）宫颈癌年轻患者,按照不同治疗方案把患者分为同步放化疗组、直接手术组以及新辅助化疗联合手术组,观察三组患者生存率、预后状况以及预后的影响因素. 结果 新辅助化疗联合手术组与手术组相比,1年、3年生存率明显要高（P＜0.05）,5年后生存率无显著差异（P＞0.05）;通过对患者预后状况的调查显示新辅助化疗联合手术组卵巢功能受损、阴道功能受损、膀胱功能受损、直肠功能障碍的发生率要明显低于同期放化疗组和直接手术组（P＜0.05）;化疗前SCC水平、淋巴结转移、肿瘤大小、宫旁浸润为预后的影响因素. 结论 由于新辅助化疗能降低并发症风险,对年轻巨块型宫颈癌患者可优先选择新辅助化疗加手术治疗方案.Objective To compare the efficacy of different treatment regimens in young patients with bulky （Ⅰ B2,Ⅱ A2） cervical cancer.Methods Totally 158 patients with bulky （Ⅰ B2,Ⅱ A2） cervical cancer in our hospital from February 2006 to January 2010 were chosen and divided into three groups：chemoradiotherapy group,direct surgery group and new adjuvant chemotherapy combined surgery group according to the treatment regimens.The survival rate,prognosis and prognostic factors were observed.Results The 1-year,3-year survival rates were significantly higher in neoadjuvant chemotherapy plus surgery group than in direct surgery group（P ＜ 0.05）,but there was no significant difference in 5-year survival rate （P ＞ 0.05）.The incidences of vaginal dysfunction,bladder dysfunction,bowel dysfunction in new adjuvant chemotherapy combined surgery group were significantly lower than those in chemoradiotherapy group and direct surgery group（P ＜ 0.05）.The SCC level,lymph node metastasis,tumor size and parametrial invasion before chemotherapy were influencing factors for prognosis.Conclusion Neoadjuvant chemotherapy can reduce the risk of complications,so for young patients with bulky cancer,neoadjuvant chemotherapy plus surgery treatment would be a priority selection.

关 键 词：巨块型宫颈癌 化疗 疗效 

分 类 号：R737.33[医药卫生—肿瘤]