局部不良型宫颈癌的综合治疗  

Combined treatment for locally advanced carcinoma of uterine cervix

作　　者：王伊洵[1] 曹品江[1] 张新[1] 曾庆东[1] 

机构地区：[1]辽宁省肿瘤医院妇科,沈阳110042

出　　处：《中华肿瘤杂志》2002年第5期508-510,共3页Chinese Journal of Oncology

摘　　要：目的　探讨局部不良型宫颈癌的综合治疗。方法　 4 0例宫颈癌术前行常规综合放疗 ,A点剂量 >70Gy 30例 ,6 0～ 70Gy 7例 ,5 0～ 5 9Gy 2例 ,4 4Gy 1例。放疗后 1～ 8周行筋膜外子宫切除术 15例 ,次广泛子宫切除术 2 3例 ,广泛性子宫切除加盆腔淋巴结清扫术 2例。结果　 2例死于夹杂症 ,12例死于肿瘤未控或复发。 3年生存率为 74 .9% ,5年生存率为 6 6 .8%。 5 0 %治疗失败发生于治疗后 1年内 ,2年内死亡率为 9/ 12 (75 .0 % )。 3例发生术后并发症 ,均经保守治疗痊愈。结论　放疗后辅以近期子宫切除的综合治疗 。Objective To evaluate the feasibility of surgical management for patients with locally advanced carcinomas of uterine cervix after radical radiation therapy who were prone to develop central recurrence. Methods These 40 patiens were treated by combined pre operative radiotherapy with dose at point A of >70 Gy in 30 patients, 60～70 Gy in 7, 50～59 Gy in 2 and 44 Gy in 1. The interval between radiation and surgery was 1 6 weeks. Extrafascial hysterectomy was performed in 15 patients, subradical hysterectomy in 23 and radical hysterectomy with pelvic lymphadenectomy in 2 cases. Results These patients have been followed up for 1 8 years with 2 died of other diseases and 12 died of cancer. Eighteen of the 26 survivors have been followed up for more than 5 years. The 3 and 5 year survival rates were 74.9% and 66.8%. Half of the death occurred within the first year after treatment with 2 year death rate of 9/12 (75.0%). Three patients suffered from long term complications after the treatment, but all were cured by conservative management. Conclusion The combination of hysterectomy performed shortly after radical radiotherapy,ie ,for patients with locally poor prognostic cervical carcinoma is reasonable and feasible.

关 键 词：局部不良型宫颈癌 综合治疗 临床分析 

分 类 号：R737.33[医药卫生—肿瘤]