本文選題：宮頸癌 + 放療　； 參考：《中華腫瘤防治雜志》2017年03期

【摘要】：目的放療是局部中晚期宮頸癌的主要治療方式,目前同步放化療已經(jīng)成為局部中晚期宮頸癌的標準治療模式,誘導化療和輔助化療在同步放化療時代的角色未明,其療效與預后的優(yōu)劣并未達成共識,本研究旨在通過回顧性分析探討局部中晚期宮頸鱗癌的最佳治療模式,為臨床治療提供理論依據(jù)。方法回顧性分析2008-01-01-2010-01-31湖南省腫瘤醫(yī)院收治的212例初治中晚期宮頸鱗癌患者,根據(jù)治療方式分為A、B和C 3組,誘導及輔助化療為TP方案,即紫杉醇聯(lián)合順鉑,同步放化療為順鉑單藥或順鉑聯(lián)合紫杉醇,A組(對照組):同步放化療82例,B組(觀察組):誘導化療聯(lián)合同步放化療98例,C組(觀察組):同步放化療聯(lián)合輔助化療32例,觀察比較3組的近期療效、遠期療效和不良反應。結果 A、B和C組近期療效分別為93.90%、94.90%和96.88%,差異無統(tǒng)計學意義,P0.05;A、B和C組總生存率(OS)第1年分別為90.24%、90.82%和87.50%;第3年分別為85.37%、87.76%和81.25%;第5年分別為82.93%、83.67%和75.00%;3組比較差異均無統(tǒng)計學意義,P0.05。A、B和C組局控率分別為86.58%、86.73%和87.50%,差異性無統(tǒng)計學意義,P0.05;A、B和C組無進展生存率分別為67.07%、74.49%和68.75%,差異均無統(tǒng)計學意義,P0.05;A、B和C組無遠處轉(zhuǎn)移生存率分別為70.73%、93.08%和71.88%,差異有統(tǒng)計學意義,P0.05。不良反應主要表現(xiàn)為觀察組3級以上白細胞及血小板減少。進一步比較觀察組間骨髓抑制差異無統(tǒng)計學意義,P0.05;消化道反應及肝功能損害3組比較差異均無統(tǒng)計學意義,P0.05;晚期放射性損傷主要表現(xiàn)為放射性直腸炎和放射性膀胱炎,3組比較差異無統(tǒng)計學意義,P0.05。結論誘導化療可以提高局部晚期宮頸癌的無遠處轉(zhuǎn)移率,有延長OS趨勢;輔助化療對局部晚期宮頸癌未見明顯生存獲益;誘導化療聯(lián)合同步放化療是一種較為有效的局部晚期宮頸癌治療方案,值得臨床進一步推廣使用,并通過大樣本資料研究加以證實。
[Abstract]:Objective radiotherapy is the main treatment method of local advanced cervical cancer. At present, synchronous radiotherapy and chemotherapy have become the standard treatment mode of local advanced cervical cancer. The roles of induction chemotherapy and adjuvant chemotherapy in the times of simultaneous radiotherapy and chemotherapy are unclear.There is no consensus between the curative effect and prognosis. The purpose of this study is to explore the best treatment mode of local advanced cervical squamous cell carcinoma by retrospective analysis, and to provide theoretical basis for clinical treatment.Methods 212 patients with cervical squamous cell carcinoma treated in Hunan Provincial Cancer Hospital from January to January 2010 to 31, 2008 were retrospectively analyzed. According to the treatment methods, 212 patients were divided into two groups: group A (group B) and group C (group C). The regimen of induction and adjuvant chemotherapy was TP regimen (paclitaxel combined with cisplatin).Simultaneous radiotherapy and chemotherapy were cisplatin single drug or cisplatin combined with paclitaxel A group (control group: 82 cases of concurrent radiotherapy and chemotherapy group B) (observation group: induced chemotherapy combined with concurrent chemotherapy group of 98 cases) (observation group: simultaneous chemotherapy and radiotherapy combined with adjuvant chemotherapy 32 cases)The short-term, long-term and adverse reactions were observed and compared among the 3 groups.Results the short-term curative effects of group A B and group C were 93.90% and 96.88%, respectively. There was no significant difference in the overall survival rate of group A (0.05) and group C (90.240.82% and 87.50% respectively in the first year; 85.377.76% and 81.25% in the third year; and 82.93% in the fifth year, 83.67% in group A and 75.00% in group C).The local control rates of group B and C were 86.58% and 87.50%, respectively. The progression-free survival rates of group B and group C were 67.07% and 68.75%, respectively. There was no significant difference between group B and C, and the survival rates of group B and C were 70.739.08% and 71.888.The difference was statistically significant (P 0.05).The main adverse reactions were leukopenia and thrombocytopenia in the observation group.There was no significant difference in bone marrow suppression between the observation group (P 0.05), digestive tract reaction and liver function damage (P 0.05).There was no significant difference among the three groups (P 0.05).Conclusion Induction chemotherapy can increase the rate of local advanced cervical cancer without distant metastasis and prolong OS trend, and adjuvant chemotherapy has no obvious survival benefit for locally advanced cervical cancer.Induction chemotherapy combined with concurrent radiotherapy and chemotherapy is an effective treatment for locally advanced cervical cancer, which is worthy of further clinical application and confirmed by a large sample of data.
【作者單位】： 湖南省腫瘤醫(yī)院·中南大學湘雅醫(yī)學院附屬腫瘤醫(yī)院婦瘤科;
【分類號】：R737.33

【相似文獻】

相關期刊論文 前10條

1 黨之俊;溫樹偉;暢俊平;苑天文;;雙側髂內(nèi)動脈灌注化療治療晚期宮頸癌臨床分析[J];山西醫(yī)藥雜志;2006年05期

2 牛書懷,呂俊玲,房朝暉;晚期宮頸癌兩種治療方法的臨床分析[J];實用癌癥雜志;1997年03期

3 張廣平,陳惠禎;化療結合放療在晚期宮頸癌治療中的作用[J];河南腫瘤學雜志;2000年02期

4 羅俊華;晚期宮頸癌34例取節(jié)育環(huán)體會[J];人民軍醫(yī);2001年03期

5 賀青蓉;介入治療30例中、晚期宮頸癌療效觀察[J];實用放射學雜志;2002年11期

6 董紅濤,王天昌;雙側髂內(nèi)動脈灌注化療加放療治療晚期宮頸癌[J];河南腫瘤學雜志;2002年01期

7 李高文,劉素云,陳志仁,鐘俊勇,朱雪連,丘全勝;晚期宮頸癌介入治療與放射治療的療效對比分析[J];中國醫(yī)學影像技術;2002年10期

8 劉興文,魏波;晚期宮頸癌合并妊娠1例[J];西北國防醫(yī)學雜志;2004年04期

9 王小京;;卡鉑輔助放射治療局部晚期宮頸癌的療效評估[J];國外醫(yī)學情報;2004年11期

10 鄭國勤,鄢龍,李瓊,雷紅衛(wèi),佘文利,陳克明;兩種介入栓塞治療晚期宮頸癌對照研究[J];長江大學學報(自科版);2005年06期

相關會議論文 前10條

1 巴彩霞;于穎卓;;晚期宮頸癌大劑量化療后輔助放療臨床分析[A];新世紀 新機遇 新挑戰(zhàn)——知識創(chuàng)新和高新技術產(chǎn)業(yè)發(fā)展（下冊）[C];2001年

2 劉雋悅;魏麗春;石梅;范風云;王莉娜;劉曉莉;;同期放化療對晚期宮頸癌的近期療效及毒性反應分析[A];2007第六屆全國放射腫瘤學學術年會論文集[C];2007年

3 吳玉梅;鄧小虹;劉冬巖;徐小紅;;加速超分割治療晚期宮頸癌——附14例近期療效觀察[A];2000全國腫瘤學術大會論文集[C];2000年

4 高國蘭;胡愛民;周艷芳;楊運勝;;放療同期聯(lián)合化療治療晚期宮頸癌的臨床研究[A];中國抗癌協(xié)會婦科腫瘤專業(yè)委員會第七次全國學術會議論文匯編[C];2003年

5 陳文兵;屈王蕾;;局部晚期宮頸癌介入治療后手術安全性分析[A];2008年浙江省婦產(chǎn)科學學術年會暨浙江省醫(yī)師協(xié)會婦產(chǎn)科醫(yī)師分會成立大會論文匯編[C];2008年

6 王中凡;張家文;;腹壁下動脈插管化療治療晚期宮頸癌的臨床觀察[A];2000全國腫瘤學術大會論文集[C];2000年

7 吳緒峰;陳慧君;;新輔助化療在局部晚期宮頸癌中的療效觀察[A];中華醫(yī)學會第九次全國婦科腫瘤學術會議論文匯編[C];2006年

8 王麗娟;林仲秋;張丙忠;周暉;陳R，

本文編號：1750674