【摘要】：目的： 通過回顧性分析136例中晚期同步放化療的宮頸癌患者5年生存率，并分析其相關(guān)預(yù)后因素，以期望找到可變因素來提高同步放化療宮頸癌患者的生存率。 資料與方法： 回顧性分析2007年3月到2008年9月遼寧省腫瘤醫(yī)院收治的136例同步放化療的宮頸癌患者，F(xiàn)IGO（國際婦產(chǎn)科聯(lián)盟）分期為IIb期和IIIb期；患者全部完成了放射治療（外照射和腔內(nèi)放療）及化療（DDP+5fu），患者生存率計算采用Kaplan—Meier法，生存率差異檢驗采用log-rank test方法，多因素分析采用Cox回歸分析方法。 結(jié)果： 中位隨訪時間為61.9個月(從4.6個月-79.6個月)，其中死亡患者共46例，死亡原因均為腫瘤復(fù)發(fā)或轉(zhuǎn)移，患者5年總體生存率為66.2%；單因素分析結(jié)果顯示患者分為青年組、中年組及老年組，總的5年生存率分別為：50%、73%和37.5%，，P=0.012，差異有統(tǒng)計學(xué)意義；IIB期和IIIB期患者的總的5年生存率分別為82.9%和60.4%，P=0.014，差異有統(tǒng)計學(xué)意義；鱗癌患者和腺癌患者的總的5年生存率分別為68.5%和16.7%，P=0.00，差異有統(tǒng)計學(xué)意義；高分化、中分化及低分化患者的總的5年生存率分別為67.7%、71%和25%，P=0.001，差異有統(tǒng)計學(xué)意義，但是高分化患者和中分化患者的5年生存率之間的差異并沒有統(tǒng)計學(xué)意義（P=0.637）；腫瘤直徑＜4cm、4—6cm和＞6cm患者的總的5年生存率分別為75%、65.2%和40%，P=0.017，差異有統(tǒng)計學(xué)意義；放化療前血紅蛋白Hb水平＜110g/L和≥110g/L的患者的總的5年生存率分別為41.7%和71.5%，P=0.012，差異有統(tǒng)計學(xué)意義；放療天數(shù)≤9周和放療天數(shù)＞9周的患者的總的5年生存率分別為76.1%和56.5%，P=0.018，差異有統(tǒng)計學(xué)意義；以上均為對患者生存時間有顯著影響的臨床病理因素，而腫瘤大體類型分為菜花型、潰瘍型、頸管型、結(jié)節(jié)型和混合型，5年生存率分別為69.8%、68.6%、100%、53.6%和50%，對患者生存率的影響無統(tǒng)計學(xué)意義（P=0.285）；多因素分析顯示臨床分期（P=0.01）、分化程度（P=0.001）、治療前血紅蛋白Hb水平（P=0.004）及完成放療時間（P=0.026）是對生存率有顯著影響的獨立預(yù)后因素。腫瘤直徑（P=0.313）、病理類型（P=0.155）、年齡（P=0.775）和腫瘤大體類型（P=0.176）對患者總的5年生存率的影響無顯著性意義。 結(jié)論： 統(tǒng)計分析結(jié)果顯示患者5年生存率與其他一些國內(nèi)和外文資料具有可比性，在中晚期宮頸癌患者臨床治療中，臨床分期和分化程度等病理因素均為不可變性因素，但是我們可通過改變患者其它可變性因素來改善宮頸癌患者的預(yù)后，例如提高治療前血紅蛋白Hb水平和嚴格遵循放療計劃避免放療間歇。
[Abstract]:Objective: to retrospectively analyze the 5-year survival rate of 136 patients with advanced cervical cancer treated with concurrent radiotherapy and chemotherapy, and analyze the related prognostic factors in order to find variable factors to improve the survival rate of cervical cancer patients with concurrent radiotherapy and chemotherapy. Materials and methods: from March 2007 to September 2008, 136 patients with cervical cancer treated in Liaoning Cancer Hospital were divided into IIb stage and IIIb stage according to the, FIGO (International Federation of Gynecology and Obstetrics and Gynecology. All patients were treated with radiotherapy (external and intracavitary radiotherapy) and chemotherapy (DDP 5fu). The survival rate was calculated by Kaplan-Meier method, log-rank test method was used for differential survival test, and Cox regression analysis was used for multivariate analysis. Results: the median follow-up time was 61.9 months (from 4.6 months to 79.6 months), of which 46 patients died. The causes of death were tumor recurrence or metastasis, and the overall 5-year survival rate was 66.2%. The results of univariate analysis showed that the patients were divided into three groups: young group, middle age group and elderly group. The overall 5-year survival rates were: 50% and 37.5%, respectively. The difference was statistically significant. The overall 5-year survival rate in patients with IIB and IIIB was 82.9% and 60.4%, respectively. The difference was statistically significant. The overall 5-year survival rate of patients with squamous cell carcinoma and adenocarcinoma was 68.5% and 16.7%, respectively. The difference was statistically significant. The overall 5-year survival rates of highly, moderately and poorly differentiated patients were 67.7% and 25%, respectively. The difference was statistically significant. However, there was no significant difference in 5-year survival rate between well-differentiated and moderately differentiated patients (P0. 637). The overall 5-year survival rates of patients with tumor diameter < 4cm ~ 4-6cm and > 6cm were 75% and 40%, respectively. The difference was statistically significant. The overall 5-year survival rates of patients with hemoglobin Hb level < 110g/L and 鈮

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