早期子宫内膜癌患者术后放疗的预后及相关影响因素

发布时间：2018-03-23 07:50

本文选题：子宫内膜癌　切入点：术后放疗　出处：《现代妇产科进展》2017年04期 　论文类型：期刊论文

【摘要】：目的:探讨早期子宫内膜癌(EC)患者术后放疗的预后及其相关影响因素。方法:选取2012年9月到2016年9月在郑州大学附属南阳医院南阳市中心医院行全子宫双附件切除术的Ⅰ期EC患者250例,根据其手术-病理分期给予术后辅助性放射治疗。术后辅助放疗方式:单纯阴道内照射108例(43.2%),盆腔外照射43例(17.2%),内外联合照射99例(39.6%)。Kaplan-Meier法计算生存率并通过Logrank检验差异,Cox模型进行预后因素分析。结果:平均随诊时间(52.58±12.35)月,5年随访率为86.4%(216/250),总随访率为83.2%(208/250)。250例患者中,10例因EC复发恶化死亡,8例因原发或继发心脑血管疾病及其它高危疾病死亡。5年总生存期率和无进展生存期率分别为92.6%和89.5%。5年总复发转移率、远处转移率、局部复发率分别为8.4%(21/250)、6.4%(16/250)和4.8%(12/250)。单因素及多因素分析均显示,影响总生存期的主要影响因素为子宫下段受累(P=0.014)和放射治疗前贫血(P=0.009)。不良反应以轻中度为主,151例(60.4%)出现1、2级急性放射性肠炎,9例(3.6%)出现3级及以上不良反应,24例(9.6%)出现其他晚期不良反应。结论:Ⅰ期EC患者术后行辅助性放射治疗后的总体临床治疗效果良好,不良反应轻微。总生存期率的影响因素为放疗前贫血和子宫下段受累。
[Abstract]:Objective: to investigate the prognosis and related factors of postoperative radiotherapy in patients with early endometrial carcinoma (ECC). Methods: select Nanyang Hospital affiliated to Zhengzhou University from September 2012 to September 2016 to perform double appendages of the uterus. Two hundred and fifty patients with stage I EC underwent resection. Adjuvant radiotherapy was given according to the stage of operation and pathology. Postoperative adjuvant radiotherapy was performed in 108 cases of intravaginal irradiation alone, 43 cases of pelvic external irradiation, and 99 cases of combined internal and external irradiation, respectively. The survival rate was calculated by using the method of 39.6% Kaplan-Meier, and the survival rate was calculated by Logrank test. Results: the mean follow-up time was 52.58 卤12.35 months, the 5-year follow-up rate was 86.4% 216 / 250, the total follow-up rate was 83.2% 208250%, 10 cases died of EC recurrence and deterioration, 8 cases died of primary or secondary heart disease and other high cerebral vascular diseases. The total 5-year survival rate and progression-free survival rate were 92.6% and 89.5.5%, respectively. The distant metastasis rate, the local recurrence rate were 8.4%, respectively, and the local recurrence rate was 6.4% (16 / 250) and 4.88% (12 / 250), respectively. Univariate and multivariate analysis showed that. The main influencing factors of total survival were P0. 014) and P0. 009 of anemia before radiotherapy. The adverse reactions were mainly mild and moderate in 151 patients with acute radiation enteritis of grade 1 and 2. (9 cases with acute radiation enteritis of grade 1 and 3. 6) and with adverse reactions of grade 3 or above in 24 cases. Conclusion: the overall clinical effect of adjuvant radiotherapy in patients with stage I EC after adjuvant radiotherapy is good. The adverse effects were mild. The factors influencing the total survival rate were anemia before radiotherapy and lower uterine involvement.
【作者单位】：郑州大学附属南阳医院南阳市中心医院放射治疗科;
【分类号】：R737.33

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