本文選題：藏族 + 漢族�。� 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:回顧性分析藏族及漢族局部晚期(IIB-IVA期)宮頸癌患者在同步放化療期間使用順鉑聯(lián)合紫杉醇類雙藥方案的臨床療效、不良反應(yīng)上的差異。方法:收集2009年07月至2015年07月四川省腫瘤醫(yī)院行同步放化療的168例IIB—VIA期宮頸癌患者,根據(jù)患者所屬民族,分為漢族組和藏族組,兩組患者外照射均采用IMRT或IGRT技術(shù),處方劑量統(tǒng)一為1.8-2.0Gy/f*23-25f,腔內(nèi)治療采用IMRT同步劑量補(bǔ)償高劑量率3D-ICBT治療,化療方案為順鉑聯(lián)合紫杉醇類雙藥方案。之后通過(guò)門(mén)診定期復(fù)查、電話溝通對(duì)兩組患者隨訪調(diào)查,評(píng)價(jià)兩組患者生存狀態(tài)、毒副反應(yīng)發(fā)生率,最后行生存分析。急慢性毒副反應(yīng)評(píng)價(jià)參考CTCEA 4.0標(biāo)準(zhǔn)。結(jié)果:1、兩組患者生存分析顯示:藏族組與漢族組3年OS分別為87.4%和86.1%(P0.05),3年P(guān)FS分別為81.2%和83.7%(P0.05),均無(wú)統(tǒng)計(jì)學(xué)差異。2、血小板減少及血紅蛋白減少發(fā)生率,藏族組均低于漢族組(分別為42.3%VS84.4%,P0.001;77.2%和93.3%,P=0.002),且白細(xì)胞及血小板III-IV°骨髓抑制發(fā)生率低于漢族組(分別為65.40%VS80.00%,P=0.033;12.80%VS28.90%,P=0.011),均有統(tǒng)計(jì)學(xué)意義。兩組患者之間的其它急慢性毒副反應(yīng)發(fā)生率的差異均未顯示出統(tǒng)計(jì)學(xué)意義。結(jié)論:對(duì)接受順鉑+紫杉醇類雙藥方案同步放化療的局部晚期宮頸患者,藏族組的部分急性毒副反應(yīng)發(fā)生率低于漢族組,但兩組患者的總生存率及無(wú)病生存率未發(fā)現(xiàn)無(wú)顯著性差異。我們還需要更大樣本量的研究及更多的隨機(jī)臨床實(shí)驗(yàn)來(lái)證實(shí)這一發(fā)現(xiàn)。
[Abstract]:Objective: to retrospectively analyze the clinical efficacy and adverse effects of cisplatin combined with paclitaxel in patients with locally advanced stage IIB-IVA cervical cancer in Tibetan and Han nationality. Methods: a total of 168 patients with IIB-VIA stage cervical cancer received simultaneous radiotherapy and chemotherapy in Sichuan Cancer Hospital from July 2009 to July 2015. According to the nationality of the patients, they were divided into Han group and Tibetan group. The patients in both groups were exposed to external irradiation with IMRT or IGRT technique. The prescribed dose was 1.8-2.0 Gy / F 23 to 25 f.The intracavitary treatment was treated with IMRT synchronous dose compensation high dose rate 3D-ICBT. The chemotherapy regimen was cisplatin combined with paclitaxel. Then the patients in the two groups were followed-up by regular outpatient reexamination and telephone communication to evaluate the survival status of the two groups and the incidence of toxic side effects. Finally survival analysis was carried out. Acute and chronic side effects were evaluated with reference to CTCEA 4. 0 standard. Results the survival of the two groups was 87.4% in the Tibetan group and 86.1% in the Han nationality group, and the PFS was 81.2% and 83.7% in the Tibetan group and the Han nationality group, respectively. The incidence of thrombocytopenia and hemoglobin decrease was not significantly different between the two groups. The incidence of bone marrow inhibition of leukocyte and platelet III-IV 擄in Tibetan group was lower than that in Han nationality group (42.3% vs 77.2% vs 93.3%, P 84.44% and P 0.002%, respectively). The incidence of leukocyte and platelet III-IV 擄inhibition in Tibetan group was lower than that in Han nationality group (65.40 VS80.003 0. 033 + 12. 80% vs 28. 90P0. 011%, respectively). There was no significant difference in the incidence of other acute and chronic side effects between the two groups. Conclusion: the incidence of partial acute side effects in the Tibetan group is lower than that in the Han nationality group. However, there was no significant difference in overall survival rate and disease-free survival rate between the two groups. We also need larger sample studies and more randomized clinical trials to confirm this finding.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.33

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本文編號(hào)：1781584