TC化疗方案联合放疗对高危子宫内膜癌术后肿瘤复发的疗效研究  

Effect of TC Chemotherapy Combined with Radiotherapy on Reduction of Tumor Recurrence after Endoscopic Surgery in Patients with High Risk Endometrial Carcinoma

作　　者：任春梅 崔素英 REN Chunmei;CUI Suying(Hospital of Chongqing Red Cross Society,Chongqing,40002)

机构地区：[1]重庆市红十字会医院,400020

出　　处：《实用癌症杂志》2018年第9期1472-1474,共3页The Practical Journal of Cancer

基　　金：重庆市卫生和计划生育委员会医学科研基金项目(编号:2015MSXM142)

摘　　要：目的探讨高危子宫内膜癌术后采用TC化疗方案与放疗联合治疗的疗效。方法选取76例经手术组织病理学诊断为高危子宫内膜癌患者进行研究,所有患者均行筋膜下子宫和双附件切除术治疗,并行盆腔和腹主动脉旁淋巴结切除术。其中术后辅以全盆外照射治疗者为对照组,术后辅以TC化疗方案,放疗方案与对照组一致的设为治疗组;两组分别为38例。结果治疗组患者腹膜后淋巴结转移率为5.26%(2/38),明显低于对照组23.68%(9/38),χ~2=5.20,P=0.02;治疗组肺转移率为2.63%(1/38),明显低于对照组18.42%(7/38),χ~2=5.02,P=0.02;治疗组阴道复发率为2.63%(1/38),明显低于对照组21.05%(8/38),χ~2=6.17,P=0.01;治疗组盆腔复发率为0.00%(0/38),明显低于对照组13.16%(5/38),χ~2=5.35,P=0.02。随访3年,治疗组患者生存率为92.11%(35/38),明显高于对照组73.68%(28/38),χ~2=4.54,P=0.03;治疗组患者骨髓抑制不良反应发生率为42.11%(16/38),明显高于对照组18.42%(7/38),χ~2=5.05,P=0.02;而两组其他不良反应发生率相比较,差异无统计学意义,P>0.05。结论高危子宫内膜癌术后采用TC化疗方案联合放疗治疗可有利于降低患者复发率,延长其生存周期,但TC化疗方案联合放疗治疗存在明显骨髓抑制,因此临床医生需加强关注以积极采取合理措施干预。Objective To explore the clinical efficacy of combined chemotherapy with radiotherapy in the treatment of high risk endometrial carcinoma. Methods 76 patients with high-risk endometrial cancer who underwent surgical histopathology were selected. All patients underwent subarachnoid and double accessory resection. And abdominal aortic lymph node dissection.The patients treated with TC chemotherapy（ intravenous infusion of paclitaxel 135 mg/m2,d1,intravenous injection of carboplatin300 mg/m2,d2,3 days after surgery） - 4 weeks for 1 cycle,2 cycles of chemotherapy after radiotherapy）,and radiation therapy were the study group and the control group received same radiation therapy 38 cases in each group. The recurrence rate of the retroperitoneal lymph nodes and lungs,vagina and pelvic recurrence rate in the 2 groups were statistically analyzed. The 3-year survival rates of the 2 groups were recorded. The adverse reactions during the treatment were recorded. Results The rate of retroperitoneal lymph node metastasis in the treatment group was 5. 26%（ 2/38）,which was significantly lower than that of the control group（ 23. 68%,χ^2= 5. 20,P = 0. 02）. The lung metastasis rate in the treatment group was 2. 63%（ 1/38） which was significantly lower than that of the control group（ 18. 42%,χ^2= 5. 02,P = 0. 02）. The vaginal recurrence rate in the treatment group was 2. 63%（ 1/38）,significantly lower than that of the control group（ 21. 05%,8/38） χ^2= 6. 17,P = 0. 01. The pelvic recurrence rate in the treatment group was 0. 00%（ 0/38）,which was significantly lower than that of the control group（ 13. 16%,5/38）. The survival rate of the patients in the treatment group was 92. 11%（ 35/38）,which was significantly higher than that of the control group（ 73. 68%,28/38）,χ^2= 4. 54,P = 0. 03. The adverse reaction rate of bone marrow suppression in the treatment group was 42. 11%（ 16/38）,significantly higher than the control group 18. 42%（ 7/38）,χ^2= 5. 05,P = 0. 02; adverse reaction

关 键 词：卡铂 紫杉醇 高危子宫内膜癌 手术 复发 

分 类 号：R737.33[医药卫生—肿瘤]