不同放化疗方案治疗宫颈癌患者的临床疗效

发布时间：2018-05-25 00:32

本文选题：宫颈肿瘤 + 同期放化疗　；参考：《肿瘤》2015年06期

【摘要】：目的 :本研究旨在探讨宫颈癌患者接受单纯放疗、同期放化疗和放疗联合辅助化疗的疗效及不良反应。方法 :研究对象为2008年10月—2013年10月在苏州大学附属第一医院放疗科接受治疗的127例宫颈癌患者。根据治疗方案分为3组:单纯放疗组45例,放疗联合同期顺铂每周化疗组58例,放疗联合辅助化疗组24例(辅助化疗方案为紫杉醇+卡铂)。3组患者均接受根治性放疗。观察3组患者的近期疗效、不良反应和生存情况。结果 :全组患者均顺利完成治疗,中位随访时间为41个月。单纯放疗组完全缓解率为53.3%(24/45),放疗联合同期顺铂每周化疗组完全缓解率为77.6%(45/58),放疗联合辅助化疗组完全缓解率为62.5%(15/24),差异无统计学意义(P=0.496)。单纯放疗组、放疗联合同期顺铂每周化疗组和放疗联合辅助化疗组患者的2年总生存率分别为66.2%、85.4%和74.9%(P0.05),3年总生存率分别为64.2%、82.4%和74.9%(P0.05),5年总生存率分别为54.8%、78.1%和74.9%(P0.05);2年无进展生存率分别为57.9%、87.2%和69.3%(P0.05),3年无进展生存率分别为56.1%、83.8%和69.3%(P0.05)。3组的不良反应主要以1~2级为主,其中白细胞减少、血小板减少、恶心呕吐和膀胱损伤发生率的差异均有统计学意义(P值均0.05)。结论 :放疗联合同期顺铂每周化疗治疗宫颈癌的疗效优于单纯放疗和放疗联合辅助化疗,可以提高总生存率和无进展生存率;但同时也应注意到同期放化疗可能引起的不良反应增加。对于不能耐受同期放化疗的患者,放疗联合辅助化疗也能取得较单纯放疗更大的生存获益。
[Abstract]:Objective: to investigate the efficacy and adverse effects of radiotherapy, radiotherapy and radiotherapy combined with adjuvant chemotherapy in patients with cervical cancer. Methods: 127 patients with cervical cancer received radiotherapy from October 2008 to October 2013 in the first affiliated Hospital of Suzhou University. The patients were divided into three groups according to the treatment regimen: radiotherapy group (n = 45), radiotherapy combined with cisplatin weekly chemotherapy group (n = 58), radiotherapy combined with adjuvant chemotherapy group (n = 24). To observe the short-term curative effect, adverse reaction and survival condition of the 3 groups. Results: all patients were successfully treated, and the median follow-up time was 41 months. The complete remission rate of radiotherapy alone group was 53.3 / 45%, that of radiotherapy combined with cisplatin weekly chemotherapy group was 77.6% / 58%, and that of radiotherapy combined with adjuvant chemotherapy group was 62.5 / 24%. There was no significant difference between the two groups (P < 0. 496). Radiotherapy alone, The 2-year overall survival rates were 66.2% and 74.9% respectively in the radiotherapy combined with cisplatin weekly chemotherapy group and radiotherapy plus adjuvant chemotherapy group, the 3-year overall survival rates were 64.22% and 74.9% respectively, the 5-year overall survival rates were 54.878.1% and 74.9P0.05%, respectively, and the 2-year progression-free survival rates were 54.878.1% and 74.9P0.05%, respectively. 57.9% and 69.3% respectively. The 3-year progression-free survival rate was 56.1% and 83.8%, respectively, and the adverse reactions in 69.3%(P0.05).3 group were mainly grade 1 and 2. The incidence of leukopenia, thrombocytopenia, nausea and vomiting and bladder injury were significantly different (P < 0.05). Conclusion: radiotherapy combined with cisplatin weekly chemotherapy is superior to radiotherapy alone and radiotherapy combined with adjuvant chemotherapy in the treatment of cervical cancer. It can improve the overall survival rate and progression free survival rate. However, it should also be noted that radiotherapy and chemotherapy may cause an increase in adverse reactions over the same period. Radiotherapy combined with adjuvant chemotherapy also has greater survival benefits than radiotherapy alone for patients who are intolerant of concurrent radiotherapy and chemotherapy.
【作者单位】：苏州大学附属第一医院放疗科;
【基金】：国家自然科学基金资助项目(编号:81302384)~~
【分类号】：R737.33

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