【摘要】：目的:探討同步放化療治療Ib2期和IIa2期宮頸癌的療效和不良反應(yīng),并分析預(yù)后影響因素。方法:回顧分析2000年1月至2010年12月首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院婦瘤科收治的73例接受同步放化療的Ib2和IIa2期宮頸癌患者的臨床病理資料。統(tǒng)計有效率和疾病控制率評價近期療效,統(tǒng)計3年、5年無瘤生存率(DFS)及總生存率(OS)評價遠期療效,記錄患者的不良反應(yīng),并分析可能影響患者預(yù)后的相關(guān)因素。結(jié)果:同步放化療治療Ib2期和IIa2期宮頸癌的有效率(CR+PR)為91.78%,疾病控制率(CR+PR+SD)為97.26%;3年DFS為84.93%,0S為86.30%;5年DFS為79.45%,0S為82.19%。所有不良反應(yīng)患者均可耐受,對癥治療后均可緩解。單因素分析顯示,患者的生存率與腫瘤的病理類型、分化程度、大小、有無淋巴結(jié)轉(zhuǎn)移以及治療前后血鱗狀細胞癌抗原(SCC-Ag)值有關(guān)(P0.05)。多因素分析表明,腫瘤病理類型、大小、有無淋巴結(jié)轉(zhuǎn)移及治療后1個月血SCC-Ag值為遠期療效的獨立影響因素。結(jié)論:同步放化療治療Ib2期和IIa2期宮頸癌的近、遠期療效肯定,不良反應(yīng)可耐受,是一種可供選擇的方法。病理類型為腺癌、腫瘤直徑㧐5cm、有淋巴結(jié)轉(zhuǎn)移、治療后1個月血SCC-Ag值≥1.5ng/ml者預(yù)后較差,需進一步加強研究。
[Abstract]:Objective: to investigate the efficacy and side effects of simultaneous radiotherapy and chemotherapy in Ib2 and IIa2 cervical cancer and to analyze the prognostic factors. Methods: the clinicopathological data of 73 patients with Ib2 and IIa2 cervical cancer who received concurrent radiotherapy and chemotherapy from January 2000 to December 2010 were retrospectively analyzed. Effective rate and disease control rate were used to evaluate the short-term curative effect, the 3-year, 5-year tumor-free survival rate (DFS) and the overall survival rate (OS) were used to evaluate the long-term efficacy. The adverse reactions were recorded, and the related factors affecting the prognosis of the patients were analyzed. Results: the effective rate of concurrent radiotherapy and chemotherapy for Ib2 and IIa2 cervical carcinoma was 91.78, the disease control rate (CR PR SD) was 97.260.The DFS for 3 years was 84.93s and 86.30, and the DFS for 5 years was 79.450S and 82.19S. All adverse reactions can be tolerated and alleviated after symptomatic treatment. Univariate analysis showed that survival rate was related to pathological type, differentiation, size, lymph node metastasis and SCC-Ag before and after treatment (P0.05). Multivariate analysis showed that tumor pathological type, size, lymph node metastasis and blood SCC-Ag value 1 month after treatment were independent factors of long-term curative effect. Conclusion: simultaneous radiotherapy and chemotherapy is an alternative method for the treatment of Ib2 and IIa2 cervical cancer. The pathological type was adenocarcinoma with a diameter of 5 cm and lymph node metastasis. One month after treatment, the prognosis of patients with SCC-Ag 鈮，

本文編號：2145209