局部晚期的藏族宫颈癌患者同步放化疗疗效及毒副反应分析

发布时间：2018-04-21 08:04

本文选题：藏族 + 汉族　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:回顾性分析藏族及汉族局部晚期(IIB-IVA期)宫颈癌患者在同步放化疗期间使用顺铂联合紫杉醇类双药方案的临床疗效、不良反应上的差异。方法:收集2009年07月至2015年07月四川省肿瘤医院行同步放化疗的168例IIB—VIA期宫颈癌患者,根据患者所属民族,分为汉族组和藏族组,两组患者外照射均采用IMRT或IGRT技术,处方剂量统一为1.8-2.0Gy/f*23-25f,腔内治疗采用IMRT同步剂量补偿高剂量率3D-ICBT治疗,化疗方案为顺铂联合紫杉醇类双药方案。之后通过门诊定期复查、电话沟通对两组患者随访调查,评价两组患者生存状态、毒副反应发生率,最后行生存分析。急慢性毒副反应评价参考CTCEA 4.0标准。结果:1、两组患者生存分析显示:藏族组与汉族组3年OS分别为87.4%和86.1%(P0.05),3年PFS分别为81.2%和83.7%(P0.05),均无统计学差异。2、血小板减少及血红蛋白减少发生率,藏族组均低于汉族组(分别为42.3%VS84.4%,P0.001;77.2%和93.3%,P=0.002),且白细胞及血小板III-IV°骨髓抑制发生率低于汉族组(分别为65.40%VS80.00%,P=0.033;12.80%VS28.90%,P=0.011),均有统计学意义。两组患者之间的其它急慢性毒副反应发生率的差异均未显示出统计学意义。结论:对接受顺铂+紫杉醇类双药方案同步放化疗的局部晚期宫颈患者,藏族组的部分急性毒副反应发生率低于汉族组,但两组患者的总生存率及无病生存率未发现无显著性差异。我们还需要更大样本量的研究及更多的随机临床实验来证实这一发现。
[Abstract]:Objective: to retrospectively analyze the clinical efficacy and adverse effects of cisplatin combined with paclitaxel in patients with locally advanced stage IIB-IVA cervical cancer in Tibetan and Han nationality. Methods: a total of 168 patients with IIB-VIA stage cervical cancer received simultaneous radiotherapy and chemotherapy in Sichuan Cancer Hospital from July 2009 to July 2015. According to the nationality of the patients, they were divided into Han group and Tibetan group. The patients in both groups were exposed to external irradiation with IMRT or IGRT technique. The prescribed dose was 1.8-2.0 Gy / F 23 to 25 f.The intracavitary treatment was treated with IMRT synchronous dose compensation high dose rate 3D-ICBT. The chemotherapy regimen was cisplatin combined with paclitaxel. Then the patients in the two groups were followed-up by regular outpatient reexamination and telephone communication to evaluate the survival status of the two groups and the incidence of toxic side effects. Finally survival analysis was carried out. Acute and chronic side effects were evaluated with reference to CTCEA 4. 0 standard. Results the survival of the two groups was 87.4% in the Tibetan group and 86.1% in the Han nationality group, and the PFS was 81.2% and 83.7% in the Tibetan group and the Han nationality group, respectively. The incidence of thrombocytopenia and hemoglobin decrease was not significantly different between the two groups. The incidence of bone marrow inhibition of leukocyte and platelet III-IV 掳in Tibetan group was lower than that in Han nationality group (42.3% vs 77.2% vs 93.3%, P 84.44% and P 0.002%, respectively). The incidence of leukocyte and platelet III-IV 掳inhibition in Tibetan group was lower than that in Han nationality group (65.40 VS80.003 0. 033 + 12. 80% vs 28. 90P0. 011%, respectively). There was no significant difference in the incidence of other acute and chronic side effects between the two groups. Conclusion: the incidence of partial acute side effects in the Tibetan group is lower than that in the Han nationality group. However, there was no significant difference in overall survival rate and disease-free survival rate between the two groups. We also need larger sample studies and more randomized clinical trials to confirm this finding.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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