本文關(guān)鍵詞： 紫杉醇 順鉑 宮頸腫瘤 預(yù)后因素 安全性　出處：《吉林大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年05期 　論文類型：期刊論文

【摘要】：目的:探討影響中晚期宮頸癌患者預(yù)后的相關(guān)因素,評(píng)價(jià)單藥順鉑與紫杉醇聯(lián)合順鉑(TP)2種方案對(duì)患者預(yù)后的影響及安全性,為中晚期宮頸癌的臨床治療提供依據(jù)。方法:選取在吉林大學(xué)第二醫(yī)院放療科行紫杉醇聯(lián)合順鉑或單藥順鉑2種同步放化療方案的中晚期宮頸癌患者218例,根據(jù)其同步放化療方案將所有患者分為單藥順鉑組和紫杉醇聯(lián)合順鉑組。所有患者均行體外照射聯(lián)合高劑量率腔內(nèi)近距離治療�；仡櫺允占�218例患者的年齡、腫瘤直徑、臨床分期、化療方案、病理等級(jí)、病理類型和初產(chǎn)年齡等臨床資料及治療后的不良反應(yīng),并通過(guò)電話隨訪及門(mén)診、住院復(fù)查資料的方式收集患者的生存資料,隨訪日期截止至2017年1月。比較2組患者臨床病理資料的差異,分析所有患者臨床病理資料與預(yù)后的關(guān)聯(lián)性并評(píng)價(jià)2種同步放化療方案的安全性。結(jié)果:2組患者年齡、腫瘤直徑、臨床分期、病理等級(jí)、病理類型和初產(chǎn)年齡比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。218例患者的1、3和5年生存率分別為96.33%、76.15%和63.76%,紫杉醇聯(lián)合順鉑組患者5年生存率高于單藥順鉑組(χ2=8.032,P=0.005)。單因素分析結(jié)果,與患者預(yù)后有關(guān)的因素是腫瘤直徑、臨床分期、化療方案和病理類型為腺癌(P0.05)。多因素分析結(jié)果,患者的臨床分期[Ⅲ期:P=0.016,HR(95%CI)=1.90(1.13~3.19);Ⅳ期:P0.001,HR(95%CI)=19.13(7.84~46.68)],化療方案[P=0.009,HR(95%CI)=0.54(0.34~0.86)]和病理類型為腺癌[P=0.021,HR(95%CI)=1.88(1.10~3.21)]是其預(yù)后的獨(dú)立影響因素,且臨床分期處于ⅡB期、采用紫杉醇聯(lián)合順鉑同步放化療方案和病理類型為鱗癌的患者預(yù)后較好。與紫杉醇聯(lián)合順鉑組患者比較,單藥順鉑組患者白細(xì)胞減少癥(Z=-2.060,P=0.039)和嗜中性粒細(xì)胞減少癥(Z=-2.246,P=0.025)不良反應(yīng)較輕。結(jié)論:臨床分期、化療方案和腺癌病理類型是中晚期宮頸癌患者預(yù)后的獨(dú)立影響因素。與采用單藥順鉑比較,采用紫杉醇聯(lián)合順鉑同步化療方案患者預(yù)后較好,且不良反應(yīng)僅略重于采用單藥順鉑。
[Abstract]:Objective: to investigate the prognostic factors of patients with advanced cervical cancer, and to evaluate the effect and safety of cisplatin and paclitaxel combined with cisplatin and TPN on the prognosis of patients with advanced cervical cancer. Methods: 218 patients with advanced cervical cancer who were treated with paclitaxel combined with cisplatin or single drug cisplatin in radiotherapy department of Jilin University second Hospital were selected. All patients were divided into single cisplatin group and paclitaxel combined with cisplatin group according to their concurrent radiotherapy and chemotherapy regimen. All patients were treated with external irradiation combined with high dose rate brachytherapy. The age and tumor diameter of 218 patients were collected retrospectively. Clinical data such as clinical stage, chemotherapy regimen, pathological grade, pathological type and age of first parturition, and adverse reactions after treatment were collected by telephone follow-up and outpatient, in-patient reexamination data. The follow-up date was up to January 2017. The differences of clinicopathological data between the two groups were compared, the correlation between clinicopathologic data and prognosis was analyzed, and the safety of two concurrent radiotherapy and chemotherapy regimens was evaluated. Tumor diameter, clinical stage, pathological grade, There was no significant difference in pathological type and age of first delivery. The 1- and 5-year survival rates of 218 patients were 96.33% and 63.76%, respectively. The 5-year survival rate in paclitaxel combined with cisplatin group was higher than that in single-drug cisplatin group (蠂 ~ 2 / 8.032P ~ (0.005)). The results of univariate analysis showed that the 5-year survival rate of patients with paclitaxel combined with cisplatin was significantly higher than that of cisplatin group. The prognostic factors were tumor diameter, clinical stage, chemotherapy regimen and pathological type. The clinical stage of the patients [stage 鈪，

本文編號(hào)：1501832