根治术后同步放化疗与放疗序贯化疗对老年宫颈癌患者生存情况的影响

发布时间：2018-06-25 21:36

  本文选题：宫颈癌根治术 + 同步放化疗　； 参考：《中国老年学杂志》2017年19期

【摘要】：目的观察根治术后同步放化疗与放疗序贯化疗对老年宫颈癌患者生存情况的影响。方法选择行宫颈癌根治术后需放化疗治疗的老年早期宫颈癌患者98例,按照患者术后治疗方式分为同步放化疗组(同步组)50例、放疗序贯化疗组(序贯组)48例,同步组放疗、化疗同步进行,而序贯组先行放疗,放疗结束后再给予辅助化疗。比较两组治疗前后细胞免疫功能、毒副作用发生情况及随访生存情况。结果治疗后两组CD3~+、CD4~+、CD4~+/CD8~+水平较治疗前均显著降低(P0.05),而CD8~+、自然杀伤(NK)细胞比例较治疗前显著升高(P0.05),治疗后两组CD3~+、CD4~+、CD8~+、CD4~+/CD8~+及NK细胞比例均无统计学差异(P0.05)。两组毒副反应主要为胃肠道反应、骨髓抑制及放射性直肠炎,且均以Ⅰ~Ⅱ度毒副作用为主,且两组均无统计学差异(P0.05);同步组3年局部无进展生存率为78.00%,序贯组为68.00%,两组差异显著(P0.05);同步组3年总体生存率为88.00%,序贯组为70.83%,两组差异显著(P0.05)。结论对于老年早期高危宫颈癌患者,术后给予患者同步放化疗可明显提高局部无进展生存率以及总体生存情况,且采取同步放化疗与序贯放化疗对患者免疫功能影响无差异,治疗毒副作用虽略有增加,但积极对症处理后患者耐受情况较好。
[Abstract]:Objective to observe the effect of concurrent radiotherapy and chemotherapy and radiotherapy sequential chemotherapy on survival of elderly patients with cervical cancer after radical operation. Methods 98 elderly patients with early cervical cancer who needed radiotherapy and chemotherapy after radical resection of cervical cancer were divided into two groups: simultaneous radiotherapy and chemotherapy group (n = 50), sequential chemotherapy group (n = 48) and radiotherapy group (n = 48). Chemotherapy was performed simultaneously, followed by radiotherapy in the sequential group, followed by adjuvant chemotherapy at the end of radiotherapy. The cellular immune function, side effects and survival were compared before and after treatment between the two groups. Results after treatment, the levels of CD3 ~ + CD4 ~ + CD4- / CD8- / CD8- were significantly lower than those before treatment (P0.05), while the percentage of CD8-, natural killer (NK) cells increased significantly (P0.05). After treatment, there was no significant difference between the two groups in the percentage of CD3 ~ + CD4- / CD4- / CD8- and NK cells (P0.05). The main side effects of the two groups were gastrointestinal reaction, bone marrow suppression and radioactive proctitis, and the main side effects were 鈪，

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