局部晚期宫颈癌术前同步放化疗疗效及安全性评价  

Clinical analysis and safety evaluation of preoperative concurrent chemo-radiotherapy for patients with locally advanced cervical cancer

作　　者：邵佳[1] 何爱琴[1] 陈曾燕[1] 

机构地区：[1]南通大学附属肿瘤医院妇科,江苏南通226361

出　　处：《中国肿瘤外科杂志》2014年第5期282-284,287,共4页Chinese Journal of Surgical Oncology

摘　　要：目的探讨术前同步放化疗在局部晚期宫颈癌治疗中的疗效及安全性。方法 2007年1月至2010年12月对70例Ⅰb2期及Ⅱa2期宫颈癌患者行PVB或TP或TC方案化疗结合腔内后装放疗后再行根治性子宫切除术,观察宫颈局部肿瘤变化及同步放化疗毒副反应,分析术前同步放化疗对局部晚期宫颈癌患者的疗效及安全性。结果 70例患者中完全缓解和部分缓解分别为14例和45例,总有效率为84.3%。3年局部复发率为31.3%,3年远处转移率为25.4%,3年总生存率为79.1%。毒副反应发生情况,骨髓抑制30.0%(21/70),周围神经毒性10.0%(7/70),胃肠道反应80.0%(56/70),肌肉关节痛12.9%(9/70),脱发87.1%(61/70)。手术平均出血量410 m L,手术平均时间160min。术后输尿管尿瘘2例,尿潴留12例,盆腔淋巴囊肿合并感染1例,均对症治疗后痊愈。结论局部晚期宫颈癌术前同步放化疗能够获得较为理想的治疗效果,毒副反应可耐受,不影响后续的手术治疗,术后并发症轻微,具有良好的临床应用前景。Objective To evaluate the efficacy and safety of preoperative concurrent chemo-radiotherapy in patients with locally advanced cervical cancer. Methods 70 patients with stageⅠb2 andⅡa2 cervical cancer were treated by PVB,TP or TC chemotherapy program and brachytherapy before radical hysterectomy from Jan. 2007 to Dec. 2010. The changes of local cervical tumor and the toxicity of concurrent chemo-radiotherapy in patients were observed and its efficacy and safety were analyzed accordingly. Results The complete remission and partial remission were 14 cases and 45 cases in 70 patients;total effective rate was 84. 3%. Three-year local recurrence rate was 31. 3%,three-year distant metastasis rate was 25. 4% and three-year overall survival rate was 79. 1%. The incidence of adverse reaction,bone marrow suppression was 30. 0%（21/70）,peripheral neurotoxicity was 10. 0%（7/70）,gastrointestinal reaction was 80. 0%（56/70）,muscle and joint pain, 12. 9%（9/70）,hair loss was 87. 1%（61/70）. The mean operative blood loss was 410 ml,mean operation time was 160 minutes. There were 2 cases of postoperative urinary fistula,12 cases of postoperative urinary retention and 1 case of pelvic lymphocyte infection,all patients were cured after symptomatic treatment. Conclu-sions Preoperative concurrent chemo-radiotherapy for locally advanced cervical cancer patients can achieve ideal treatment results：toxicity can be tolerated and does not affect subsequent treatment,postoperative complications are minor. Preoperative concurrent chemo-radiotherapy has good prospects for clinical application.

关 键 词：宫颈癌 局部晚期 同步放化疗 后装放疗 疗效评价 

分 类 号：R737.33[医药卫生—肿瘤]