李从铸, 许少榆①, 周 莉, 朱 彦. 术前同步放化疗在局部晚期宫颈癌治疗中的应用[J]. 中国肿瘤临床, 2010, 37(21): 1242-1244. DOI: 10.3969/j.issn.1000-8179.2010.21.010
引用本文: 李从铸, 许少榆①, 周 莉, 朱 彦. 术前同步放化疗在局部晚期宫颈癌治疗中的应用[J]. 中国肿瘤临床, 2010, 37(21): 1242-1244. DOI: 10.3969/j.issn.1000-8179.2010.21.010
LI Congzhu1, XU Shaoyu2, ZHOU Li1, ZHU Yan1. Preoperative Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(21): 1242-1244. DOI: 10.3969/j.issn.1000-8179.2010.21.010
Citation: LI Congzhu1, XU Shaoyu2, ZHOU Li1, ZHU Yan1. Preoperative Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(21): 1242-1244. DOI: 10.3969/j.issn.1000-8179.2010.21.010

术前同步放化疗在局部晚期宫颈癌治疗中的应用

Preoperative Concurrent Chemoradiotherapy for Locally Advanced Cervical Cancer

  • 摘要: 目的:分析术前同步放化疗治疗局部晚期宫颈癌的可行性及其疗效。方法:将1995年11月~2008年12月期间,汕头大学医学院附属肿瘤医院收治的259 例宫颈肿瘤最大径>4cm的ⅠB2~ⅡB 期宫颈癌患者分为3 组,其中术前同步放化疗组(A组)64例,术前单纯放疗组(B 组)73例,直接手术组(C 组)122 例,对比A 组和B 组术前放化疗或放疗后宫颈肿块消退情况、不良反应,以及A 组、B 组和C 组3 组术后病理分析宫颈浸润、宫旁浸润、阴道浸润、脉管浸润、淋巴结转移情况及患者生存情况分析。结果:宫颈肿块体积术前同步放化疗组术前放化疗后较术前单纯放疗组术前放疗后明显缩小,差异有统计学意义(P<0.05);术前同步放化疗组骨髓抑制及胃肠道反应与术前单纯放疗组比较差异无统计学意义(P>0.05)。 术后病理分析显示术前同步放化疗组宫颈浸润明显少于术前单纯放疗组及直接手术组,差异有统计学意义(P<0.05);脉管浸润术前同步放化疗组明显少于术前单纯放疗组及直接手术组,差异有统计学意义(P<0.05);但宫旁浸润、阴道残端浸润及盆腔淋巴结转移的发生率各组比较差异无统计学意义(P>0.05);生存情况分析3 组1、3、5 年生存率无统计学意义(P>0.05)。 结论:局部晚期宫颈癌患者术前行同步放化疗其疗效肯定,且安全可行,值得进一步研究。

     

    Abstract: Objective: To evaluate the feasibility and curative effect of preoperative concurrent chemoradiotherapy on locally advanced cervical cancer. Methods:From November1995to December 2008, 259 patients with stage ⅠB2- ⅡB cer-vical cancer from the Cancer Hospital of the Medical College of Shantou University with local lesions averaging >4 cm in di-ameter were enrolled and randomly divided into three groups. The preoperative concurrent chemoradiotherapy group in-cluded 64participants, the preoperative radiotherapy group had 73participants and the surgery alone group included 122 participants. The tumor volume reduction, adverse effects, pathological features, and survival rates were compared among the groups. Results:The tumor volume reduction in the preoperative concurrent chemoradiotherapy group after chemoradio-therapy was more significant ( P<0.05) than that in the preoperative radiotherapy group after radiotherapy. There was no sig -nificant difference in adverse effects between those two groups (P> 0.05). Pathology studies showed that the group with preoperative concurrent chemoradiotherapy had less infiltration of the cervix than the group with preoperative radiotherapy alone and the group with surgery alone (P<0.05). The group with preoperative concurrent chemoradiotherapy had fewer in-stances of vascular thrombosis than the group with preoperative radiotherapy alone and the group with surgery alone, with a significant difference ( P<0.05). Parametrium infiltration, vaginal infiltration and lymph node metastasis rates were similar among the 3 groups ( P>0.05). Survival analysis for the three groups at 1, 3, and 5 years after treatment were similar, with-out a significant difference (P>0.05). Conclusion:The patients with locally advanced cervical cancer treated with preopera-tive concurrent chemoradiotherapy had more reduction in tumor size than those who did not receive such treatment. Pre -operative concurrent chemoradiotherapy can be considered safe, feasible, and worthy of further study.

     

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