Ⅳ期宫颈癌治疗效果及预后因素的综合分析  

Efficacy analysis and prognostic factors of stageⅣcervical cancer

作　　者：秦雪[1] 高嵩[1] QIN Xue;GAO Song(Department of Gynaecology and Obstetrics,Shengjing Hospital of China Medical University,Liaoning Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院妇科,辽宁沈阳110022

出　　处：《现代肿瘤医学》2021年第21期3820-3824,共5页Journal of Modern Oncology

基　　金：辽宁省科技厅自然基金指导计划(编号:2019-ZD-0785)。

摘　　要：目的:评估与全身化疗或姑息放疗的单一治疗手段相比,放化疗综合治疗对伴有远处转移的Ⅳ期宫颈癌患者预后的影响。方法:回顾性分析2010年12月至2020年05月中国医科大学附属盛京医院收治的50例初始诊断为Ⅳ期宫颈癌患者资料,经过靶向、放疗、化疗等治疗,分析比较其基本条件、生存情况、生存时间及不良反应。结果:所有患者的中位生存时间为25.8个月(5~54个月),分析数据时仍在世的32例患者中位生存时间为29.8个月(15.7~54个月);全组生存率半年以上约98%(49/50),1年以上86%(43/50),2年以上生存率54%(27/50)。分组比较中位生存时间较长的为肺转移组、无骨转移组、锁骨上淋巴结转移组及Ⅳb期,但差异无统计学意义。年龄小于54岁、肿瘤标志物变化有反应型患者中位生存时间更长,且差异有统计学意义。单因素分析显示,年龄及病理类型影响预后。治疗方式是影响宫颈癌的独立因素(P<0.05),使用放化疗综合治疗的宫颈癌患者死亡风险低于单一方案治疗的患者;且先放疗后化疗组的患者其死亡风险更低于先化疗后放疗的宫颈癌患者,HR 0.296,95%CI 0.112~0.78,P=0.014。所有患者治疗过程中及治疗后未见明显不良反应。结论:多方案个体化治疗对提高Ⅳ期宫颈癌疗效有积极意义,先放疗后化疗治疗方案效果更佳,且未见明显不良反应,安全有效。Objective:To evaluate the efficacy and safety of individualized therapy for stageⅣcervical cancer.Methods:Data of 50 patients initially diagnosed with stageⅣcervical cancer admitted to Shengjing Hospital of Chinese Medical University from December 2010 to May 2020 were retrospectively analyzed.After comprehensive treatment including targeting,radiotherapy and chemotherapy,their basic conditions,survival conditions,survival time and adverse reactions were analyzed and compared.Results:The median survival time of the whole series was 25.8 months(rang 5~54 months),and the median survival time of the living patients was 29.8 months(range 15.7~54 months).The overall survival rate was 98%(40/50)over half a year,86%(43/50)over 1 year,and 54%(27/50)over 2 years.The median survival time was longer in the lung metastasis group,the bone-free metastasis group,the supraclavicular lymph node metastasis group,the premorphic and post-emplacement group,and theⅣb stage,but there was no statistical difference.Age less than 54 years old and tumor marker changes showed a higher median survival time of response type,and there was a statistical difference.Age,pathological type and treatment mode were identified as independent prognostic factors in cervical cancer patients.The risk of death of patients treated with radiotherapy and chemotherapy was lower than that of patients treated with single regimen.No adverse reactions were observed in all patients during and after treatment.Conclusion:Individualized treatment has positive significance in improving the curative effect of stageⅣcervical cancer.Radiotherapy followed by chemotherapy is more effective and no obvious adverse reactions are observed.It is safe and effective.

关 键 词：个体化治疗 Ⅳ期宫颈癌 预后 

分 类 号：R737.9[医药卫生—肿瘤]