根治性同步放化疗+手术治疗局部晚期宫颈癌:一项随机对照试验的中期结果分析  

Concomitant chemoradiation followed by radical surgery for locally advanced cervical cancer patients: preliminary results from a randomized, controlled trial

作　　者：郑建清[1] 黄碧芬 周云清[3] 黄双英[3] 陈少蓉[3] 李鲁宏[3] 

机构地区：[1]福建医科大学附属第二医院放射治疗科,福建泉州362000 [2]福建泉州医学高等专科学校附属人民医院妇产科,福建泉州362000 [3]福建医科大学附属第二医院妇产科,福建泉州362000

出　　处：《中国循证医学杂志》2017年第1期1-6,共6页Chinese Journal of Evidence-based Medicine

基　　金：福建医科大学附属第二医院苗圃基金项目(编号:2013MP16)

摘　　要：目的初步评价根治性同步放化疗+手术治疗局部晚期宫颈癌的疗效。方法将102例局部晚期宫颈癌患者随机分为试验组和对照组。对照组单纯采用根治性同步放化疗,化疗方案为单药顺铂35~40 mg/m^2,每周1次。试验组在对照组基础上,联合广泛性全子宫切除术及盆腔淋巴结清扫术,宫旁组织和阴道组织各切除3 cm。结果试验组纳入52例患者,对照组纳入50例。试验组术后病理资料显示无癌残留率为82.7%,癌残留率为5.8%。试验组无进展生存时间为3~40月,中位生存时间为23月,3年生存率为73.1%;对照组无进展生存时间为5~41月,中位生存时间为22月,3年生存率为64.8%;两组差异无统计学意义(χ~2=0.092,P=0.761)。试验组总生存时间为6~40月,中位总生存时间为23月,3年生存率为82.7%;对照组总生存时间为5~41月,中位生存时间为22.5月,3年生存率为81.8%;两组差异也没有统计学意义(χ~2=0.338,P=0.561)。结论局部晚期宫颈癌采用根治性同步放化疗+手术治疗不能显著提高无进展生存率和总生存率,目前对局部晚期宫颈癌患者的治疗需更谨慎并结合患者病情考虑是否使用该治疗方法。Objective To evaluate the radical chemoradiotherapy plus surgery for locally advanced cervical patients. Methods 102 cases of patients with locally advanced cervical cancer were randomly divided into a trial group and a control group. In the control group, patients received radical chemoradiotherapy only, with chemotherapy consisted of cisplatin 35-40 mg/m2, one times a week. In the trial group, patients received both treatment in the control group and extensive hysterectomy and pelvic lymph node dissection. Results Fifty-two patients were randomly enrolled into the trial group and 50 patients into the control group. The microscopic residual tumor （MRT） rate was 5.8% （3/52） and nonmicroscopic residual tumor （NMRT） rate was 82.7% （43/52） in the trial group. Progression-free survival time was 3-40 months with a median survival time of 23 months, and the 3-year progression-free survival rate was 73.1% in the trial group, and progression-free survival time was 5-41 months with a median survival time of 22 months, and the 3-year progression-free survival rate was 64.8% in the control group; while the difference was not statistically significant （χ2=0.092, P=0.761）. Overall survival time was 6-40 months with median overall survival time of 23 months, and the 3- year overall survival rate was 82.7% in the trial group, and overall survival time was 5-41 months with a median survival time of 22.5 months, and the 3-year overall survival rate was 81.8%; while the difference was not statistically significant （χ2=0.338, P=0.561）. Conclusion Concomitant chemoradiation followed by radical surgery could not significantly improve progression-free survival and overall survival in patients with locally advanced cervical cancer. The treatment regimen should be applied with caution and selectivity.

关 键 词：宫颈癌 化学治疗 放射治疗 手术治疗 随机对照试验 

分 类 号：R737.33[医药卫生—肿瘤]