同步放化疗联合p53腺病毒治疗中晚期宫颈癌近期疗效分析

发布时间：2018-05-05 06:06

  本文选题：宫颈癌 + 同步放化疗　； 参考：《安徽医科大学》2017年硕士论文

【摘要】：目的通过比较同步放化疗与同步放化疗联合重组人p53腺病毒注射液在中晚期宫颈癌治疗前后的影像学表现及DNA倍体定量分析结果,评价同步放化疗联合重组人p53腺病毒注射液治疗中晚期宫颈癌的近期临床疗效。方法将符合入组条件的142例初治的中晚期宫颈癌患者随机分为治疗组(同步放化疗联合重组人p53基因治疗)42例和对照组(同步放化疗)100例。治疗组患者于放疗前72小时行重组人p53腺病毒注射液瘤内注射一次,此后每周行瘤内注射一次,连续2~4次。两组患者均采用三维适形调强放疗(IMRT)的体外照射方式配合铱-192腔内治疗,且放疗剂量及放疗方式相同;同时两组患者于放疗开始第一周的周六或周日行“顺铂40mg/m2”同步化疗,连续6周。治疗结束2月后,复查盆腔增强MRI,通过测量肿瘤最大截面积(肿瘤最长直径×垂直径的最大宽度),以此观察患者肿瘤大小变化及评估治疗疗效;并分别于治疗前、后采用妇科宫颈脱落细胞采集刷刷取宫颈细胞,行DNA倍体定量分析,依据两组患者治疗前、后宫颈细胞DNA指数(DNA index,DI)≥2.5细胞个数的变化评估近期临床治疗疗效。结果治疗结束2月后,复查盆腔增强MRI,结果示治疗组患者治疗前、后与对照组相比,瘤体消退较为理想。治疗组42例病人,CR 26例(61.9%);PR 12例(28.6%);有效率90.5%;对照组100例病人,CR 28例(28%);PR 36例(36%);有效率64%;其中治疗组有效率明显高于对照组(90.5%VS 64.0%;P0.05),有统计学意义。DNA倍体定量分析结果示治疗前治疗组与对照组差异无统计学意义(χ~2=0.953,P=0.329)。治疗结束后治疗组与对照组差异具有统计学意义(χ~2=6.558,P=0.01)。结论影像学及DNA倍体定量分析结论一致,提示重组人p53腺病毒联合同步放化疗治疗中晚期宫颈癌近期疗效优于同步放化疗组。
[Abstract]:Objective to compare the imaging findings and quantitative analysis of DNA ploidy between simultaneous radiotherapy and chemotherapy combined with recombinant human p53 adenovirus injection before and after treatment for advanced cervical cancer. To evaluate the clinical efficacy of concurrent radiotherapy and chemotherapy combined with recombinant human p53 adenovirus injection in the treatment of advanced cervical cancer. Methods 142 newly treated patients with advanced cervical cancer were randomly divided into treatment group (n = 42) and control group (n = 100). Patients in the treatment group were injected with recombinant human p53 adenovirus injection 72 hours before radiotherapy. The patients in both groups were treated with three dimensional conformal intensity modulated radiotherapy (IMRT) in vitro combined with intracavitary iridium 192, and the same dose of radiotherapy and radiotherapy were used in both groups. Meanwhile, the patients in both groups received "cisplatin 40mg/m2" concurrent chemotherapy on Saturday or Sunday of the first week of radiotherapy. Six weeks in a row. After 2 months of treatment, the pelvic enhanced MRI was re-examined to observe the tumor size and evaluate the therapeutic efficacy by measuring the tumor maximum cross-sectional area (the longest diameter of tumor 脳 the largest width of the vertical diameter). Then the cervical cells were collected and brushed by exfoliated cells of gynecological cervix, and the quantitative analysis of DNA ploidy was performed. According to the changes of DNA index of cervical cells (DNA index) 鈮，

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