不同放化疗方案治疗宫颈癌患者的临床疗效  

Clinical outcomes of patients with cervical carcinoma receiving different radiochemotherapy regimens

作　　者：王骁[1] 徐晓婷[1] 李莉[1] 王利利[1] 周菊英[1] 

机构地区：[1]苏州大学附属第一医院放疗科,江苏苏州215006

出　　处：《肿瘤》2015年第6期653-659,共7页Tumor

基　　金：国家自然科学基金资助项目(编号:81302384)~~

摘　　要：目的 ：本研究旨在探讨宫颈癌患者接受单纯放疗、同期放化疗和放疗联合辅助化疗的疗效及不良反应。方法 ：研究对象为2008年10月—2013年10月在苏州大学附属第一医院放疗科接受治疗的127例宫颈癌患者。根据治疗方案分为3组：单纯放疗组45例,放疗联合同期顺铂每周化疗组58例,放疗联合辅助化疗组24例（辅助化疗方案为紫杉醇＋卡铂）。3组患者均接受根治性放疗。观察3组患者的近期疗效、不良反应和生存情况。结果 ：全组患者均顺利完成治疗,中位随访时间为41个月。单纯放疗组完全缓解率为53.3%（24/45）,放疗联合同期顺铂每周化疗组完全缓解率为77.6%（45/58）,放疗联合辅助化疗组完全缓解率为62.5%（15/24）,差异无统计学意义（P=0.496）。单纯放疗组、放疗联合同期顺铂每周化疗组和放疗联合辅助化疗组患者的2年总生存率分别为66.2%、85.4%和74.9%（P〈0.05）,3年总生存率分别为64.2%、82.4%和74.9%（P〈0.05）,5年总生存率分别为54.8%、78.1%和74.9%（P〈0.05）;2年无进展生存率分别为57.9%、87.2%和69.3%（P〈0.05）,3年无进展生存率分别为56.1%、83.8%和69.3%（P〈0.05）。3组的不良反应主要以1~2级为主,其中白细胞减少、血小板减少、恶心呕吐和膀胱损伤发生率的差异均有统计学意义（P值均〈0.05）。结论 ：放疗联合同期顺铂每周化疗治疗宫颈癌的疗效优于单纯放疗和放疗联合辅助化疗,可以提高总生存率和无进展生存率;但同时也应注意到同期放化疗可能引起的不良反应增加。对于不能耐受同期放化疗的患者,放疗联合辅助化疗也能取得较单纯放疗更大的生存获益。Objective： To investigate the efficacy and toxicity of radiotherapy alone, concurrent radiochemotherapy and radiotherapy combined with adjuvant chemotherapy for patients with cervical carcinoma.Methods： Total of 127 patients with cervical cancer receiving radiotherapy in the First Affiliated Hospital of Soochow University between October 2008 and October 2013 were enrolled into this study and divided into three groups： radiotherapy alone group（n = 45）, radiotherapy with concurrent cisplatin chemotherapy group（n = 58） and radiotherapy combined with adjuvant chemotherapy（paclitaxel plus carboplatin） group（n = 24）. All patients in the three treatment groups received radical radiotherapy including pelvic external radiotherapy and 192 Ir brachytherapy. The efficacy, toxicities and survival of three groups were observed.Results： All patients finished treatment. The median follow-up time was 41 months. The rates of complete response of radiotherapy alone group, radiotherapy with concurrent cisplatin chemotherapy group and radiotherapy combined with adjuvant chemotherapy group were 53.3%（24/45）, 77.6%（45/58） and 62.5%（15/24）, respectively（P = 0.496）; the 2-year overall survival rates of these three treatment groups were 66.2%, 85.4% and 74.9%, respectively（P 〈 0.05）; the 3-year overall survival rates were 64.2%, 82.4% and 74.9%, respectively（P 〈 0.05）; the 5-year overall survival rates were 54.8%, 78.1% and 74.9%, respectively（P 〈 0.05）; the 2-year progression-free survival rates were 57.9%, 87.2% and 69.3%, respectively（P 〈 0.05）; the 3-year progression-free survival rates were 56.1%, 83.8% and 69.3%, respectively（P 〈 0.05）. The toxicities were mainly in grades 1-2. There were no significant differences in the rates of leucopenia, thrombocytopenia, nausea and vomiting and bladder injury among the three treatment groups（all P 〉 0.05）. Conclusion： The efficacy of radiotherapy with concurrent cisplatin chemotherapy regimen for patients with cervi

关 键 词：宫颈肿瘤 同期放化疗 辅助化疗 铂类 紫杉醇 

分 类 号：R737.33[医药卫生—肿瘤]