同期放化疗的宫颈癌患者预后的多因素分析  

Multivariate prognostic factors analysis for patients with cervical cancer after concurrent chemoradiation

作　　者：岳成山 胡勇[1] 王会霞[1] 高山[1] 张晶晶[2] 李冬[1] 董学良[1] 王佩[1] 余昌 

机构地区：[1]汉中市中心医院放疗科,陕西汉中723000 [2]汉中市中心医院肿瘤内科,陕西汉中723000

出　　处：《现代肿瘤医学》2014年第9期2174-2176,共3页Journal of Modern Oncology

摘　　要：目的:总结我科收治的宫颈癌患者同步放化疗的治疗结果,并分析影响预后的因素。方法:2006年1月1日-2010年12月31日收治的170例Ib1-IVa宫颈癌患者进入回顾性研究。化疗选用含顺铂的三个方案之一,放疗采用外照射加192Ir高剂量率腔内后装照射,A点总剂量78-90Gy,B点外照射剂量46-56Gy。将患者的临床分期、盆腔及主动脉旁淋巴结情况、肿瘤大小(>or≤4cm)、肿瘤消退情况、肿瘤标志物作为分析因素,用COX回归对上述分析因素与无进展生存期(progression-free survival,PFS)和总生存期(overall survival,OS)的关系进行单因素和多因素分析。结果:单因素和多因素分析显示影响PFS的因素有:临床分期(P<0.01),肿瘤大小(P<0.01),肿瘤消退情况(P=0.01)和肿瘤标志物(P=0.01)。影响OS的因素为:临床分期(P=0.01),肿瘤大小(P=0.01)与肿瘤消退情况(P<0.01)。5年生存率Ib1-Ⅱa期患者为:91.5%,Ⅱb期患者为:70.8%,Ⅲ期患者为:42.7%,IVa期患者为:20.5%。结论:同步放化疗治疗不能手术切除的宫颈癌患者,影响预后的主要因素是临床分期、肿瘤大小和肿瘤消退情况。Objective:To evaluate the outcomes and the prognostic factors for cervical cancer after chemoradi-ation.Methods:A total of 170 patients with stage Ib1 -IVa who were treated in our hospital between January 2006 and December 2010 were reviewed and analyzed.All patients received 3D-CRT radiotherapy with one of three regimens of cisplatin-based chemotherapy concurrently and 192 Ir high-dose rate brachytherapy.The total dose of point A ran-ges 78-90Gy and point B ranges 46-56Gy.Sage,lymph node status,tumor size(>or≤4cm),clinical response and tumor marker were used as analysis factors for COX regression univariate and multivariate analyses .Results:Stage (P<0.01),tumor size (P<0.01),clinical response(P=0.01),and tumor marker(P=0.01)were statisti-cally significant,based on univariate and multivariate analyses of PFS according to these factors.Based on analysis on OS,stage(P=0.01),tumor size(P=0.01),and clinical response(P<0.01)showed a significant outcome.The 5 -year survival rates were 91.5% for stages Ib1 -Ⅱa,70.8% for stage Ⅱb,42.7%for stage Ⅲ,and 20.5%for stage IVa.Conclusion:The main prognostic factors of the patients with unresectable cervical cancer treated with concurrent radiochemotherapy are sage,tumor size and clinical response.

关 键 词：宫颈癌 同期放化疗 预后因素 

分 类 号：R737.33[医药卫生—肿瘤]