宫颈癌ⅡB期术前同期放化疗联合根治术与根治性放疗同期化疗疗效对比  

Comparison of therapeutic efficacy between concurrent preoperative radiochemotherapy combined with radical surgery and radical radiotherapy combined with concurrent chemotherapy for cervical cancer in stage ⅡB

作　　者：陈晓梅[1] 陈世洪[1] 王越希 王琳[1] 

机构地区：[1]自贡市第一人民医院,四川自贡643000

出　　处：《武警后勤学院学报（医学版）》2017年第3期208-211,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨采用术前同期放化疗联合根治术和根治性放疗同期化疗治疗宫颈癌ⅡB期患者的疗效及预后影响,并研究影响预后的因素。【方法】纳入2011年1月至2013年12月FIGOⅡB期宫颈癌患者共177例,94例接受同期放化疗加根治术患者为放化疗手术组,83例接受根治性放疗同期化疗为放化疗组。比较两组患者的3年无进展生存率(progression-free survival,PFS)、总生存率(overall survival,OS),采用Kaplan-Meier法计算生存率,Cox法进行预后影响因素分析。【结果】177例患者均完成治疗和随访,放化疗手术组和放化疗组3年PFS为90.4%和74.7%(P<0.05);3年OS分别为92.6%和78.3%(P<0.05)。肿瘤直径(≥6 cm)和年龄(≤35岁)为放化疗手术组预后因素(P<0.05)。病理类型(非鳞癌)、肿瘤直径(≥6 cm)为放化疗组预后因素(P<0.05)。放化疗手术组患者发生放射性肠炎、放射性膀胱炎人数少于放化疗组,发生下肢水肿多于放化疗组,两组差异有统计学意义(P<0.05)。【结论】ⅡB期宫颈癌患者进行术前同期放化疗联合根治术的疗效及预后情况较根治性放疗同期化疗的情况较好,肿瘤直径是影响两种治疗方法的预后影响因素。【Objective】To explore the therapeutic efficacy of concurrent preoperative radiochemotherapy combined with radical surgery and radical radiotherapy combined with concurrent chemotherapy for cervical cancer in stage ⅡB,and study the influencing factors on prognosis.【Methods】A total of 177 cases with cervical cancer in stage FIGO ⅡB were enrolled from January 2011 to December 2013.There were 94 patients treated with concurrent radiochemotherapy and radical surgery in the radiochemotherapy-operation group,and 83 cases treated with radical radiotherapy and concurrent chemotherapy in the radiotherapy-chemotherapy group.The 3-year progression-free survival（PFS） and overall survival（OS） were compared between the two groups.The Kaplan-Meier method was used to calculate the survival rate and Cox method was used to analyze the influencing factors on prognosis.【Results】The treatment and follow-up were performed in all 177 patients.The values of 3-year PFS in the radiochemotherapy-operation group and radiotherapy-chemotherapy group were respectively 90.4% and 74.7%（P〈0.05）,while the values of 3-year OS were respectively 92.6% and 78.3%（P〈0.05）.The influencing factors on prognosis in the radiochemotherapy-operation group included tumor diameter（≥6 cm） and age（≤35 y）（P〈0.05）,while those in the radiotherapy and chemotherapy group included pathological types（non-squamous cell carcinoma） and tumor diameter（≥6 cm）（P〈0.05）.The patients with radiation enteritis and radiation cystitis in the radiochemotherapy and operation group were fewer than those in the radiotherapy and chemotherapy group.However,the patients with lower extremity edema in the radiochemotherapy and operation group were more than those in the radiotherapy and chemotherapy group.The difference between the two groups was statistical（P〈0.05）.【Conclusion】The therapeutic efficacy of concurrent preoperative radiochemotherapy combined with radical operation and prognosis are better than that of

关 键 词：宫颈癌 同期放化疗 根治性手术 根治性放疗 预后 

分 类 号：R737.33[医药卫生—肿瘤]