放疗联合多方案化疗治疗局部晚期宫颈癌的临床研究  

Clinical study of concurrent radiotherapy with different chemotherapy regimens for advanced cervical cancer

作　　者：王海蓉[1] 戴东方 武雅琴[1] WANG Hairong;DAI Dongfang;WU Yaqin(Department of Radiation Oncology,Jiangsu Cancer Hospital/Jiangsu Institute of Cancer Research/The Affiliated Cancer Hospital of Nanjing Medical University,210009 Nanjing,China)

机构地区：[1]江苏省肿瘤医院/江苏省肿瘤防治研究所/南京医科大学附属肿瘤医院放疗科,江苏南京210009

出　　处：《中国肿瘤外科杂志》2022年第5期435-440,共6页Chinese Journal of Surgical Oncology

基　　金：国家自然科学基金青年项目(81802598);江苏省妇幼健康科研课题(F202165)。

摘　　要：目的回顾性分析放疗联合多方案化疗治疗局部晚期宫颈癌的临床疗效。方法收集并分析2012年1月至2013年2月在江苏省肿瘤医院行同步放化疗的124例宫颈癌患者的临床病理资料,根据化疗方案分为周化疗组和周期化疗组,对不同方案化疗患者的不良反应、疗效及预后进行亚组分析。结果研究发现周化疗组与周期化疗组有效率分别为97.56%(40/41)与96.39%(80/83)(P=0.916)。1、3、5年的总生存率分别为95.1%、68.3%、65.9%与90.4%、72.3%、67.5%(P=0.572,0.645,0.845)。周化疗组与周期化疗组之间的不良反应差异无统计学意义(P>0.05),但周期化疗组患者共4例发生了Ⅳ度骨髓抑制,发生率和严重程度高于周化疗组患者。肿瘤复发及远处转移是两组患者的主要死亡原因。两组患者之间的死亡率差异无统计学意义(P>0.05)。结论局部晚期宫颈癌患者放疗过程中行周化疗与周期化疗的疗效相似,两种方案中患者不良反应无明显差异,出于经济考虑和并发症的考虑,可优先选择同步周化疗方案。Objective To investigate the clinical efficacy of concurrent radiotherapy with different chemotherapy regimens in the treatment of advanced cervical cancer.Methods Retrospective analysis was performed on the clinicopathological data of 124 cervical cancer patients receiving chemoradiotherapy in Jiangsu Provincial Cancer Hospital from January 2012 to February 2013.Subgroup analysis was performed on the incidence of adverse reaction,curative effect and prognosis between the groups with different chemotherapy regiment.Results The effective rate of the patients receiving weekly chemotherapy was 97.56%,which was higher than that(96.39%)of the patients receiving periodic chemotherapy(P=0.916).There were differences on 1,3,5 years overall survival(OS)rate between the patients receiving weekly chemotherapy and periodic chemotherapy respectively(95.1%,68.3%,65.9%vs 90.4%,72.3%,67.5%,P=0.572,0.645,0.845).There was no significant difference on the incidence of adverse reaction and mortality between the two groups of patients(P>0.05).Four cases of bone marrow suppression withⅣdegrees occurred in the patients treated with periodic chemotherapy.The main causes of death in both groups included distant metastasis and tumor recurrence.Conclusions The efficacy was similar between weekly chemotherapy and periodic chemotherapy.In consideration of medical cost and complications,weekly chemotherapy should be preferentially applied.

关 键 词：宫颈癌 中晚期 放疗 同步化疗 

分 类 号：R737.33[医药卫生—肿瘤]