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目的观察具有高危因素或手术范围不够的宫颈癌病人术后放疗的疗效和并发症。方法对北京妇产医院199001-200412的97例FIGOⅠA～ⅡB手术后行放疗的宫颈癌患者,计算其5年存活率,观察治疗并发症。并对我院同期ⅠA～ⅡA单独手术治疗、ⅡB单独放疗的宫颈癌患者进行统计学分析,以比较观察各组术后放疗的效果。结果97例术后放疗的患者5年存活率为71.1%,其中ⅠA期为87.5%,ⅠB期为73.7%,ⅡA期为63.6%,ⅡB期为60.0%。总的Ⅰ、Ⅱ期5年存活率分别为75.4%、62.5%。单独手术和单独放疗的病例,Ⅰ期5年存活率为87.8%,Ⅱ期为80.4%。单独手术的宫颈癌患者,ⅠA期5年存活率为97.2%,ⅠB期84.5%,ⅡA期77.8%;单独放疗的ⅡB期宫颈癌患者5年存活率为80.8%。总的单独手术和单独放疗的病例的5年存活率,Ⅰ期为87.8%,Ⅱ期为80.4%。结论具有高危因素的I、II期宫颈癌术后放疗疗效差,尤其在诸如手术范围不够多个或多组淋巴结转移、脉管瘤栓、不良病理类型、癌细胞分化不良者,对于这些病例的治疗方案尚待进一步的研究。
Objective To observe the curative effect and complications of postoperative radiotherapy for patients with cervical cancer who have high risk factors or not enough surgical scope. Methods Ninety-seven patients with cervical cancer who underwent radiotherapy from FIGOⅠA to ⅡB in 199001-200412 of Beijing Maternity and Childbearing Hospital were enrolled. The 5-year survival rate was calculated and the complications were observed. And the same period in our hospital Ⅰ A ~ Ⅱ A separate surgery, Ⅱ B radiotherapy alone cervical cancer patients for statistical analysis to compare the effect of postoperative radiotherapy. Results The 5-year survival rate of 97 patients with postoperative radiotherapy was 71.1%, of which 87.5% were in stage IA, 73.7% in stage IB, 63.6% in stage IIA and 60.0% in stage IIB. The overall 5-year survival rates of stage I and stage II were 75.4% and 62.5%, respectively. Cases of surgery alone and radiotherapy alone, Ⅰ 5-year survival rate was 87.8%, Ⅱ period of 80.4%. The 5-year survival rate of stage ⅠA was 97.2%, stage Ⅰ B 84.5% and stage Ⅱ A 77.8%. The 5-year survival rate of stage ⅡB cervical cancer alone was 80.8%. The 5-year survival rates of patients undergoing total surgery alone and radiotherapy alone were 87.8% in stage I and 80.4% in stage II. Conclusions The postoperative radiotherapy for patients with stage I and II cervical cancer with high risk factors is ineffective, especially in those cases where there are not many or multiple groups of lymph node metastases, vascular tumor thrombus, poor pathological types, and poorly differentiated cancer cells Treatment options yet to be further studied.