同步放化疗与单纯放疗治疗中晚期宫颈癌疗效及毒性反应比较研究  

Retrospective study of chemoradiotherapy compared with radiothrepy alone for cervical cancer

作　　者：杜俊瑶[1,2] 张新[1] 李联崑[1] 王纯雁[1] 王晓彬[1] 于明新[1] 

机构地区：[1]辽宁省肿瘤医院妇科,辽宁沈阳110042 [2]大连医科大学研究生院

出　　处：《中国实用妇科与产科杂志》2015年第3期256-260,共5页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的对比分析顺铂＋氟尿嘧啶（PF方案）同步放化疗和单纯放疗治疗中晚期宫颈癌患者的疗效和毒性反应。方法回顾性分析2007年3月至2008年10月辽宁省肿瘤医院收治的ⅡB~Ⅲ期宫颈癌患者共264例,分为同步放化疗组132例和单纯放疗组132例,对比分析两组患者的疗效和毒性反应。结果同步放化疗组和单纯放疗组患者的（完全缓解＋部分缓解）有效率分别为96.2%和91.7%,差异无统计学意义（P〉0.05）。同步放化疗组与单纯放疗组5年生存率分别为68.9%和62.1%,差异有统计学意义（HR=2.794,P〈0.01）。两组ⅡB期患者的5年生存率分别为84.8%和73.0%（P〉0.05）。两组Ⅲ期患者的5年生存率分别为63.6%和48.3%（P〈0.05）。同步放化疗组和单纯放疗组近期毒性反应以骨髓抑制为主,其中3级以上白细胞减少发生率分别为20.5%和4.5%（P〈0.01）。3级以上放射性直肠炎发生率分别为0.7%和2.3%、3级以上放射性膀胱炎发生率分别为3.8%和1.5%（均P〉0.05）。结论同步放化疗能提高Ⅲ期宫颈癌患者的5年生存率。3级以上白细胞减少的发生率增加,3级以上放射性直肠反应、放射性膀胱反应的发生率不增加,毒性反应可以接受。Objective To compare the treatment effects and toxicities after concomitant chemoradiotherapy（CRT） and radiothrepy（RT） alone for advanced cervical cancer.Methods A total of 264 patients with stages Ⅱ B ~ Ⅲ from Liaoning Cancer Hospital between Mar. 2007 to Oct. 2008 were analyzed retrospectively,132 in the CRT and 132 in the RT. Results The rates of the effieiency（CR＋PR） was 96.2% in the CRT and 91.7% in the RT, respectively （P〉0.05）. Pa- tients allocated to the CRT group had a significantly better 5-year overall survival （HR=2.794; P〈0.01） compared with women in the RT.They were separately 68.9% and 62.1%.The OS of stage Ⅲ B was 84.8% in the CRT and 73.0% in the RT（P〉0.05） . The OS of stage m was 63.6% in the CRT and 48.3% in the RT（P〈0.05）.Grade 3 leukoeytopenia was 20.5% and 4.5% （P〈0.01）.Grade 3- 4 radiation proctitis was 0.7% and 2.3% （P〉0.05）. Grade3 ~ 4 radiocystitis was 3.8% and 1.5% （P〉0.05）.Conclusions For stage Ⅲ cervical cancer, the CRT improved the 5-year overall survival with acceptable toxicity. Grade 3 leukocytopenia is increased, grade 3 ~ 4 severe late toxicity , such as radiation proctitis, ra- diocystitis, is not increased.

关 键 词：宫颈肿瘤 同步放化疗 放射治疗 

分 类 号：R737.3[医药卫生—肿瘤]