同步放化疗治疗晚期宫颈癌的临床分析_临床医学论文.docVIP

同步放化疗治疗晚期宫颈癌的临床分析_临床医学论文 同步放化疗治疗晚期宫颈癌的临床分析_临床医学论文 【摘要】 目的：观察同步放化疗治疗晚期宫颈癌的临床疗效,毒副作用及远期并发症。方法：87例Ⅲb期宫颈癌患者,按信封法随机分为同步放化疗组(A组)和单纯放疗组(B组), A组采用顺铂40 mg/d静脉滴注,化疗6个周期,每周重复,同时进行根治性放射治疗,放疗第1天开始行化疗,放疗采用加速器体外照射, Ir192腔内后装治疗,体外剂量45 Gy/25f /5w (17f后中央挡铅),腔内照射A点总剂量42 Gy/6f。单纯放射治疗组仅行单纯放疗,方法同化放组,不行化疗。结果：A、B 组近期疗效比较,差异有统计学意义(0.05)。A 组和B 组的5 年生存率分别为58%和32%。差异有统计学意义(0.05),A、B组毒性反应及远期并发症比较,差异无统计学意义(Pgt;0.05)。结论：同步放化疗治疗晚期宫颈癌可增强疗效,提高生存率,毒副作用无明显增加。 【关键词】 宫颈肿瘤；放射疗法；抗肿瘤联合化疗方案 ［ABSTRACT］ Objective: To observe the clinical effect, adverse reaction, side effect, and longterm complication of concurrent chemotherapy and radiotherapy for cervical cancer. Methods: Divided 87 cervical cancer cases at Ⅲb stage into concurrent chemotherapy and radiotherapy group (A group) and radiotherapy group (B group) by envelop method. A group was treated by DDP 40 mg/d intravenous drip for 6 cycles, repeated every week. At the same time, radical radiotherapy was administered by intracavity afterloading therapy with onedaily external irradiation doses of 45Gy/25f/5w and brachytherapy to deliver a total dose 42Gy /6f to point A (The center of whole pelvic field was blocked after 17f). B group was treated by only radiotherapy. Results: The difference of shortterm efficacy between two groups was significant (0.05). 5year survival rates were 58% and 32% respectively with significant difference (0.05).There was no significant difference in adverse effect and longterm complication (Pgt;0.05). Conclusion: Concurrent chemotherapy and radiotherapy for cervical cancer can strengthen therapeutic efficacy, elevate survival rate, and reduce adverse effect. ［KEY WORDS］ Cervical cancer; Radiotherapy; Antineoplastic combined chemotherapy protocols 宫颈癌是最常见的妇科恶性肿瘤,晚期宫颈癌常采用放射治疗,但单纯放射治疗的疗效仍较差。近几年,化学治疗已被广泛运用。放射治疗与化疗同步治疗也越来越受到人们的重视［1］。为探讨顺铂加放射治疗和单纯放射治疗中、晚期宫颈癌的疗效,我院自2005年1月～2007年1月将收治的87例晚期(Ⅲa～Ⅳa)宫颈癌患者随机分成两组, 探讨同步放化疗在中晚期宫颈癌治疗中的疗效及其安全性,现报告如下。 1 临床材料 1.1 一般资料 　本组87 例患者,中位年龄49 岁(33～75 岁)。均经病理确诊的宫颈鳞癌,未作过任何抗癌治疗的初治患者;一般情况好,心、肾、肝等