早期子宫内膜癌治疗方法探究.doc

早期子宫内膜癌治疗方法探究[摘要] 目的 讨论多种医疗方式治疗初期子宫内膜癌的疗效及预后。 方法 回顾性分析我院早期子宫内膜癌患者185例临床资料，将其分为单纯手术组（n=28）、单纯放疗组（n=37）、术后放疗组（n=50）、术前全量放疗组（n=35）、术前腔内后装组（n=35），比较各组5年生存率、局部复发率、远处转移率和放疗并发症等指标。 结果 单纯放疗组和术前腔内后装组的5年生存率差异有统计学意义（P ＜ 0.05）；单纯手术组和单纯放疗组与其他三组间的局部复发率差异均有统计学意义（P ＜ 0.05）；各组之间的远处转移率差异无统计学意义（P 0.05）；术前腔内后装组放射性肠炎的发生率与其他各组放射性肠炎的发生率差异有统计学意义（P＜0.05）。结论 治疗早期子宫内膜癌的技术是主要以手术为主的综合治疗，术前全量放疗差于术前腔内后装放疗。术前、术后放疗均能有效地降低患者的局部复发率，但并不能改善远处转移。 [关键词] 子宫内膜癌；放射疗法；外科手术 [中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210（2012）01（c）-0050-03 Exploration of therapies for early endometrial cancer CHEN Yaling Department of Obstetrics and Gynecology, the Central Hospital of Zhumadian City, He’nan Province, Zhumadian 463000, China [Abstract] Objective To discuss the curative effect and prognosis of variety therapies for early endometrial cancer. Methods The clinical datas of 185 cases of patients with early endometrial cancer in our hospital were analyzed retrospectively. All patients were divided into simple operation group (n=28), simple radiotherapy group (n=37), postoperative radiotherapy group (n=50), preoperative whole amount radiotherapy group (n=35) and the intracavitary afterloading group (n=35). The five-years survival rate, local recurrence rate, distant metastasis rate, complications of radiotherapy and other indicators of each group were compared. Results The survival rate was compared between the simple radiotherapy group and the preoperative intracavitary afterloading group, the difference was significant (P 0.05). The incidence of radiation enteritis of the preoperative intracavitary afterloading group were different from other groups significantly (P 0.05）。见表1。 表1 各组患者一般情况（例） 1.2 方法 单纯手术组：切掉全部子宫以及双附件或者在此基础上清除盆腔淋巴结。单纯放疗组：给予全盆外照射和腔内后装放疗的单纯根治性放疗，DT 45~50 Gy，L5上缘、闭孔下缘及真骨盆外侧1.5 cm为照射的边界，进行全盆外照射，将放疗点A和F设置在腔内后处。术后放疗组：术后对患者进行全盆外照射，照射按DT 45~50 Gy，腔内后装放疗的照射野为DT 14~21 Gy，位置在阴道黏膜下0.5 cm。术前全量放疗组：在手术前先进行全量放疗，然后在放疗后4~8周期间切除整个子宫、双附件并清扫盆腔淋巴结。术前腔内后装组：在腔内后装A点、F点，按上述方法进行放疗，放疗治疗结束3周后，再采用单纯