早期宫颈癌术后预后与不同放疗方式的疗效及并发症比较

发布时间：2018-01-22 19:27

本文关键词： 宫颈癌放射治疗预后疗效并发症　出处：《中国肿瘤临床》2017年06期 　论文类型：期刊论文

【摘要】：目的:探讨影响早期宫颈癌患者术后预后的因素和不同放疗方式的疗效及并发症情况。方法:回顾性分析2013年3月至9月100例新疆医科大学附属肿瘤医院及中山大学附属肿瘤医院收治的早期宫颈癌术后患者资料,并对影响患者预后的因素进行分析。根据放疗方式分为常规放疗(conventional radiotherapy,CRT)组50例,图像引导调强放疗(image guided radiotherapy,IGRT)组50例,并比较两组的疗效和并发症情况。结果:100例患者3年生存率和无瘤生存率分别为89%和78%。CRT组和IGRT组3年生存率分别为78.57%和89.06%,两组比较差异具有统计学意义(P=0.034);CRT组和IGRT组3年无瘤生存率分别为66.67%和87.36%,两组比较差异具有统计学意义(P=0.042)。CRT组和IGRT组早期、晚期并发症的比较差异具有统计学意义(P0.05)。单因素分析显示宫旁浸润、淋巴结转移、肿瘤浸润深度、淋巴脉管间隙浸润、神经侵犯、术后放疗与早期宫颈癌3年生存率相关(P0.05)。Cox多因素分析显示术后放疗方式、宫旁浸润、淋巴结转移、淋巴脉管间隙浸润、神经侵犯及肿瘤浸润深度均为影响早期宫颈癌患者预后的独立危险因素。结论:早期宫颈癌的预后是多因素相互作用的结果,术后IGRT组3年生存率明显优于CRT组,放疗不良反应小,有益于患者的生存质量。
[Abstract]:Objective: to investigate the factors influencing the postoperative prognosis of patients with early cervical cancer and the curative effect and complications of different radiotherapy methods:. From March 2013 to September, the data of 100 patients with early cervical cancer treated in the affiliated Cancer Hospital of Xinjiang Medical University and the affiliated Cancer Hospital of Sun Yat-sen University were analyzed retrospectively. According to the method of radiotherapy, 50 patients were divided into conventional radiotherapy group (CRT) and conventional radiotherapy group (CRT). Image guided radiotherapymetric group (50 cases). The curative effect and complications of the two groups were compared. The 3-year survival rate and tumor-free survival rate were 89% and 78.CRT in 100 patients and 78.57% and 89.06% in IGRT group, respectively. The difference between the two groups was statistically significant. The 3-year tumor-free survival rates of CRT group and IGRT group were 66.67% and 87.36, respectively. The difference between the two groups was statistically significant. Univariate analysis showed para-uterine invasion, lymph node metastasis, depth of tumor invasion, lymphatic vascular space infiltration, nerve invasion. Post-operative radiotherapy was associated with the 3-year survival rate of early cervical cancer. Multivariate analysis showed that postoperative radiotherapy, periuterine invasion, lymph node metastasis, lymphatic vascular space infiltration. Nerve invasion and depth of tumor invasion are independent risk factors for the prognosis of early cervical cancer patients. Conclusion: the prognosis of early cervical cancer is the result of multivariate interaction. The 3-year survival rate of IGRT group was significantly better than that of CRT group.
【作者单位】：新疆医科大学附属肿瘤医院妇科放射治疗科;新疆医科大学附属肿瘤医院妇外四科;中山大学附属肿瘤医院放疗科;
【基金】：新疆维吾尔自治区科学技术厅科技支疆项目(编号:2013911130)资助~~
【分类号】：R737.33
【正文快照】： 宫颈癌是全球女性第四大常见恶性肿瘤[1],我国尿测定。放疗医师根据ICRU83号文件完成靶区勾每年宫颈癌新发病例约10万人,居我国女性生殖系画。分割剂量为1.8 Gy/次,处方剂量45 Gy,95%以上统恶性肿瘤首位[2]。早期宫颈癌手术切除与根治性的计划靶区(planning target volume,PTV

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