Ⅰ~Ⅲ期宫颈癌治疗后肺转移28例临床分析  

Clinical Analysis of 28 Cases of Stage Ⅰ~Ⅲ Cervical Cancer with Pulmonary Metastasis After Treatment

作　　者：刘瑶[1] 宋丹[1] 孔为民[1] 

机构地区：[1]首都医科大学附属北京妇产医院,北京100006

出　　处：《肿瘤学杂志》2016年第12期1004-1008,共5页Journal of Chinese Oncology

摘　　要：[目的]探讨宫颈癌治疗后肺转移的临床特点,评价紫杉醇联合卡铂或顺铂（TC/TP方案）对宫颈癌治疗后肺转移的疗效和安全性,并分析预后影响因素。[方法]收集28例接受TC/TP方案化疗的宫颈癌治疗后肺转移患者的临床资料,分析其临床特点,观察TC/TP方案的有效率、疾病控制率及患者的不良反应,并探讨预后影响因素。[结果]28例患者中有16例为早期（Ⅰb-Ⅱa期）术后患者;12例为Ⅱb－Ⅲb期患者。28例患者肺转移发生时间在原发疾病治疗1－5年内。肺转移发生后TC/TP方案有效率（CR＋PR）为46.4%,疾病控制率（CR＋PR＋SD）为60.7%,中位生存时间18个月,5年生存率10.7%,Ⅲ-Ⅳ级胃肠道反应、骨髓抑制及肾毒性发生率分别为5.0%、15.0%、0;单因素分析影响肺转移患者的预后因素,结果显示宫颈癌的病理类型、分化程度、原发肿瘤大小、肺转移灶的大小与宫颈癌肺转移患者的生存率有关（P〈0.05）,多因素分析显示,仅宫颈癌的分化程度是宫颈癌肺转移患者预后的独立影响因素。[结论]要重视宫颈癌治疗后发生肺转移的问题;TC/TP方案对宫颈癌治疗后肺转移患者有效且不良反应能耐受;对于这些患者中的低分化者应加强治疗方法的研究及监测。[Objective] To analyze the clinical characteristics and relevant treatment of cervical cancer patients with pulmonary metastasis after the treatment. [Methods] The complete clinical data of cervical cancer patients with pulmonary metastasis after the treatment were retrospectively analyzed. Among 28 patients,16 were stage Ⅰ b - Ⅱ a,and 12 were stage Ⅱ b - Ⅲ b;pulmonary metastasis occurred within 5 years after initial treatment. All patients received TC/TP chemotherapy,the overall response rate,disease control rate and toxicity reactions of chemotherapy were observed. And the relevant prognostic factors were also analyzed. [Results] The overall response rate（CR＋PR）and disease control rate（CR＋PR＋SD）of TC/TP chemotherapy were 46.4%,60.7%,respectively. The median survival time was 18 months,and the 5-year survival rate was 10.7%.The incidence rates of Ⅲ-Ⅳ grade of gastrointestinal reaction,bone marrow suppression and renal toxicity were 5.0%,15.0%,0,respectively. The univariate analysis showed that pathological type,differentiated degree,size of primary tumor,size of pulmonary metastasis were closely related to the prognosis（P〈0.05）,while only the differentiation of cervical tumor was an independent prognostic factor in multivariate regression analysis. [Conclusion] Attention should be paid to pulmonary metastasis after the treatment of cervical cancer,particularly for patients with low differentiation tumor. The TC/TP regimen is effective with tolerable toxicity,and can be widely used in patients with pulmonary metastasis after the treatment of cervical cancer.

关 键 词：宫颈肿瘤 肺转移 治疗 预后 

分 类 号：R737.33[医药卫生—肿瘤]